CAJ | 학술논문

目的评价氟脱氧葡萄糖(FDG)PET-CT常规及双时相显像在监测食管癌术后复发转移中的应用价值.方法回顾分析食管癌术后临床怀疑复发转移而行FDG PET-CT检查的48例患者临床资料,根据细胞学、病理或随访结果分析FDG PET-CT检查结果.两样本率比较采用Fisher's精确概率法检验.结果 48例患者中位随访21.5个月,34例出现复发转移,确定复发转移灶61处.FDG PET-CT常规显像对全部病灶诊断的敏感性、特异性和准确性分别为93.44%、74.29%和86.46%;对局部复发和区域淋巴结转移的敏感性、特异性、准确性分别为91.67%、57.14%、78.95%和90.48%、77.78%、84.62%.FDG PET-CT双时相显像诊断局部复发+区域淋巴结转移的敏感性、特异性、准确性均高于常规显像,分别为96.97%∶90.90%(P=0.613)、96.00%∶72.00%(P=0.049)、96.55%∶82.76%(P=0.029).结论 FDG PET-CT常规显像虽然检测食管癌术后局部复发及区域淋巴结转移的特异性和准确性较低,但仍是检测其术后复发转移的有效手段;双时相显像较常规显像更具优势,可有效提高检测的特异性及准确性.
목적 평개불탈양포도당(FDG)PET-CT상규급쌍시상현상재감측식관암술후복발전이중적응용개치.방법 회고분석식관암술후림상부의복발전이이행FDG PET-CT검사적48례환자림상자료,근거세포학、병리혹수방결과분석FDG PET-CT검사결과.량양본솔비교채용Fisher's정학개솔법검험.결과 48례환자중위수방21.5개월,34례출현복발전이,학정복발전이조61처.FDG PET-CT상규현상대전부병조진단적민감성、특이성화준학성분별위93.44%、74.29%화86.46%;대국부복발화구역림파결전이적민감성、특이성、준학성분별위91.67%、57.14%、78.95%화90.48%、77.78%、84.62%.FDG PET-CT쌍시상현상진단국부복발+구역림파결전이적민감성、특이성、준학성균고우상규현상,분별위96.97%∶90.90%(P=0.613)、96.00%∶72.00%(P=0.049)、96.55%∶82.76%(P=0.029).결론 FDG PET-CT상규현상수연검측식관암술후국부복발급구역림파결전이적특이성화준학성교저,단잉시검측기술후복발전이적유효수단;쌍시상현상교상규현상경구우세,가유효제고검측적특이성급준학성.
Objective To evaluate the clinical value of regular and dual-time-point 18-fluorodeoxyglucose positron emission tomography-CT(FDG PET/CT)imaging for recurrence and metastasis in esophageal carcinoma(EC)after curative esophagectomy. Methods A retrospective study was done on 48 patients received curative esophagectomy, who underwent FDG PET/CT scans to detect doubtful recurrent or metastatic lesions. The diagnostic accuracy of FDG PET-CT was assessed with the help of pathological findings as well as clinical or follow-up data. Using Fisher's Exact Test from SPSS 11.5 to analyze the data.Results Of the 48 patients, after a median follow-up of 21.5 months, 61 sites of local and regional recurrence or metastasis were finally confirmed in 34 patients. The sensitivity, specificity and accuracy of regular FDG PET/CT imaging in detecting recurrence of all sites were 93.44%, 74.29% and 86.46%respectively. The specificity and accuracy of local recurrence and regional metastasis were 57.14% ,78.95% and 77.78% ,84.62%, respectively. The sensitivity, specificity and accuracy of dual-time-point FDG PET/ CT imaging in detecting local and regional recurrence(96.97% ,96.00% and 96.55%)were higher than those of regular FDG PET/CT(90.90%, 72.00% and 82.76%)and there were significant differences of specificity and accuracy(P = 0.049, P = 0.029). Conclusions Regular FDG PET/CT imaging is highly effective in detecting recurrence and metastasis in EC patients after curative esophagectomy despite the low specificity and accuracy. Dual-time-point FDG PET/CT imaging can elevate the specificity and accuracy.