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本文主要研究目的是探讨18-氟代脱氧葡萄糖(~(18)F-FDG)单光子发射计算机断层(SPECT/CT)代谢显像在宫颈癌治疗前准确分期及预测预后等方面的临床价值。回顾了27例宫颈癌患者,均行全身~(18)F-FDG SPECT/CT显像,所有图像均通过图像融合软件进行分析。准确测量宫颈癌原发灶、淋巴结的大小及T/B(靶/本底)值。采用SPSS17.0分析比较宫颈癌原发灶T/B值与各临床病理因素之间的关系。病灶根据组织病理学检查、影像学检查及随访确诊。结果显示27例宫颈癌患者宫颈原发灶的T/B值为5.9(3.2),并随临床分期的增加而逐渐增大,≥Ⅱa期者明显高于≤Ⅰb期者(P<0.05);而原发灶的T/B值与原发灶最大径、淋巴结转移、病理类型等无明显关系(P>0.05)。27例宫颈癌患者全身~(18)F-FDG显像检出13处转移淋巴结;18 F-FDG代谢显像诊断淋巴结转移的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为75.0%、78.9%、77.8%、60.0%、88.2%。转移淋巴结的T/B值为6.3(3.5),其中远处转移淋巴结的T/B值明显高于盆腔淋巴结(P<0.05);淋巴结T/B值与淋巴结大小无明显关系(P>0.05)。17例患者宫体摄取FDG,其中15例患者经病理证实:2例为宫颈癌浸润宫体;13例为子宫内膜生理性改变摄取FDG,前者T/B值明显高于后者(P<0.05)。宫体浸润与淋巴结转移阳性呈正相关(P<0.05)。本研究显示,~(18)F-FDG代谢显像对盆腔外和远处淋巴结转移及宫体浸润的诊断具有明显价值,有利于准确分期,并且宫颈癌原发灶的T/B值与分期有关,可在一定程度上反映患者的危险度,初步预测患者预后。
The main purpose of this paper is to investigate the clinical value of 18F-FDG single photon emission computed tomography (SPECT / CT) imaging in the accurate staging and prognosis of cervical cancer before treatment. Twenty-seven patients with cervical cancer were retrospectively reviewed. All patients underwent ~ (18) F-FDG SPECT / CT imaging. All the images were analyzed by image fusion software. Accurate measurement of cervical cancer primary tumor, lymph node size and T / B (target / background) value. Using SPSS17.0 analysis of cervical cancer primary T / B value and the relationship between the various clinical and pathological factors. According to histopathological examination lesions, imaging studies and follow-up diagnosis. The results showed that the T / B value of cervical primary tumor in 27 cases of cervical cancer was 5.9 (3.2), and gradually increased with the increase of clinical stage (P <0.05). The T / B value of primary tumor had no significant relationship with the maximum diameter of primary tumor, lymph node metastasis and pathological type (P> 0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 18 F-FDG metabolic imaging in diagnosing lymph node metastasis were all detected in 27 cases of cervical cancer with ~ (18) F-FDG imaging. 75.0%, 78.9%, 77.8%, 60.0%, 88.2%. The T / B value of lymph node metastasis was 6.3 (3.5). The T / B value of distant metastasis lymph node was significantly higher than that of pelvic lymph node (P <0.05). There was no significant correlation between lymph node T / B value and lymph node size (P> 0.05) . FDG was detected in 17 cases of uterine body, of which 15 cases were confirmed by pathology: two cases were uterine cervix infiltration; 13 cases were FDG physiological changes in endometrium, the former T / B value was significantly higher than the latter (P < 0.05). There was a positive correlation between uterine body invasion and lymph node metastasis (P <0.05). This study showed that ~ (18) F-FDG metabolic imaging has obvious value in the diagnosis of extra-pelvic and distant lymph node metastasis and uterine body infiltration, which is conducive to accurate staging, and the T / B value and stage of cervical cancer primary tumor Related, to a certain extent, reflect the risk of patients, the initial prognosis of patients.