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目的探讨18F-FDG PET/CT显像在宫颈癌术后复发和转移中的应用价值。方法搜集临床可疑宫颈癌术后复发和转移患者65例,年龄23~77岁,平均48.7岁。所有宫颈癌患者均经手术病理确诊并行根治性治疗,其中鳞癌47例,腺癌12例,腺鳞癌4例,透明细胞癌1例,小细胞癌1例。患者均行18F-FDG PET/CT全身显像检查,采用目测法和半定量法判断结果,并与组织病理或临床随访结果比较其诊断的准确性,以及评价其诊断的真实性和可靠性。结果 65例患者经组织病理或临床随访证实50例复发和转移。18F-FDG PET/CT显像诊断肿瘤局部复发18例,肿瘤转移33例,复发和转移病灶的SUVmax 2.91~16.70,平均SUVmax 9.81,18F-FDG PET/CT显像诊断宫颈癌术后复发和转移的灵敏度为98.00%,特异性为86.67%,准确性为95.38%,阳性预测值为96.08%,阴性预测值为92.86%;18F-FDG PET/CT显像诊断结果与组织病理或临床随访结果比较差异无统计学意义(经χ2检验,P>0.05);二者结果的吻合度有统计学意义且吻合度较强(系数k=0.867,P=0.000)。结论18F-FDG PET/CT显像能够准确、直观地显示宫颈癌术后复发和转移,且真实性和可靠性好;同时18F-FDG PET/CT全身显像检查是肿瘤远处转移探测最有效的方法,可较全面评估患者病情,对协助临床确定个体化治疗方案具有重要价值。
Objective To investigate the value of 18F-FDG PET / CT in the diagnosis of cervical cancer recurrence and metastasis. Methods Sixty-five patients with clinically suspected cervical cancer recurrence and metastasis were collected, aged 23-77 years, with an average of 48.7 years. All cervical cancer patients were diagnosed by pathology and radical treatment, including squamous cell carcinoma in 47 cases, adenocarcinoma in 12 cases, adenosquamous carcinoma in 4 cases, clear cell carcinoma in 1 case and small cell carcinoma in 1 case. All patients underwent 18F-FDG PET / CT whole body imaging examination. Visual and semi-quantitative methods were used to judge the results. The accuracy of diagnosis was compared with histopathological or clinical follow-up results, and the authenticity and reliability of the diagnosis were evaluated. Results 65 patients were confirmed by histopathology or clinical follow-up of 50 cases of recurrence and metastasis. 18F-FDG PET / CT imaging diagnosis of local recurrence in 18 cases of cancer, 33 cases of tumor metastasis, recurrence and metastasis of SUVmax 2.91 ~ 16.70, mean SUVmax 9.81,18 F-FDG PET / CT diagnosis of cervical cancer recurrence and metastasis The sensitivity was 98.00%, the specificity was 86.67%, the accuracy was 95.38%, the positive predictive value was 96.08% and the negative predictive value was 92.86%. The diagnostic value of 18F-FDG PET / CT imaging was compared with the histopathological or clinical follow-up results The difference was not statistically significant (χ2 test, P> 0.05). The concordance between the two was statistically significant and the agreement was good (coefficient k = 0.867, P = 0.000). Conclusion 18F-FDG PET / CT imaging can accurately and directly show the recurrence and metastasis of cervical cancer, and its authenticity and reliability are good. At the same time, 18F-FDG PET / CT whole body imaging is the most effective method to detect distant metastasis of tumor The method can be more comprehensive assessment of the patient’s condition, to help determine the clinical treatment of individual programs of great value.