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目的 转移性肿瘤原发灶的定位对指导组织学诊断及选择治疗方式具有重要意义。本文对50例原发灶不明转移癌患者进行~(18)F-FDG PET全身显像,以评价其在探测原发灶中的价值。 方法 50例原发灶不明转移癌患者,男36例,女14例,其中颈部转移瘤18例,骨骼转移瘤15例,脑转移瘤12例,其他5例。所有患者均进行FDG PET全身显像,结果判断应用目测法和半定量分析方法(标准摄取值,SUV)。 结果 50例患者中,有32例PET可检出原发灶(64％),且经组织学或细胞学证实,其中肺癌17例,鼻咽癌9例,乳腺癌2例,卵巢癌、结肠癌、前列腺癌、甲状腺癌各1例。2例(4％)FDG PET呈假阳性,分别为子宮和结肠病变各1例。18例FDG PET显像原发灶不明者,经临床随访2～26个月,有2例发现原发灶,1例证实为前列腺癌,1例为粘液性胃癌。17例患者PET检出了其他部位的转移灶。 结论 PET一次检查可了解肿瘤原发灶及全身转移情况,包括骨骼及软组织的转移,对原发灶不明转移癌患者进行全身PET检查有助于原发灶的寻找,为临床制订治疗方案提供可靠依据。
Objectives The location of the primary tumor in metastatic tumors is of great importance for the guidance of histological diagnosis and selection of treatment modalities. In this study, 50 patients with primary metastatic carcinoma of unknown origin underwent ~ (18) F-FDG PET scintigraphy to evaluate their value in detecting primary tumor. Methods Fifty patients with primary tumor with unknown metastatic disease, including 36 males and 14 females, including 18 cervical metastases, 15 bone metastases, 12 brain metastases and 5 others. All patients underwent FDG PET whole-body imaging, the results of visual assessment and semi-quantitative analysis method (standard intake, SUV). Results Of the 50 patients, 32 cases of primary tumor (64%) were detected by PET and confirmed by histology or cytology, including 17 cases of lung cancer, 9 cases of nasopharyngeal carcinoma, 2 cases of breast cancer, 2 cases of ovarian cancer, Cancer, prostate cancer, thyroid cancer in 1 case. FDG PET was false positive in 2 cases (4%), one case of uterine and colonic lesions respectively. 18 cases of FDG PET imaging of unknown origin, after a clinical follow-up of 2 to 26 months, 2 cases found that the primary tumor, 1 case confirmed as prostate cancer, 1 case of mucinous gastric cancer. 17 patients with PET detected metastases in other parts. Conclusion A PET examination can understand the primary tumor and systemic metastases, including the metastasis of bone and soft tissue. The whole body PET examination of patients with primary metastatic cancer can help to find the primary tumor and provide a reliable clinical treatment plan in accordance with.