CAJ | 학술논문

目的探讨18F-脱氧葡萄糖(FDG)PET/CT检测肝癌治疗后甲胎蛋白(AFP)升高患者肿瘤复发和(或)转移病灶的价值.方法原发性肝细胞癌治疗后血清AFP升高患者123例,皆行全身18F-FDG PET/CT显像.所有图像经图像融合后,进行PET/CT融合图像、PET图像和CT图像帧对帧对比分析.肿瘤复发和(或)转移病灶根据病理检查结果、多种影像学诊断及临床随访而确诊.随访时间均>6个月.采用SPSS 11.5软件进行统计学处理,进行X2检验.结果 123例患者中,明确诊断肿瘤复发和(或)转移者111例.18F-FDG PET显像诊断肿瘤复发和(或)转移78例,其灵敏度为70.3%(78/111);18F.FDG PET/CT显像诊断肿瘤复发和(或)转移97例,灵敏度提高至87.4%(97/111,χ2=9.744,P=0.002).18F.FDG PET/CT诊断肝癌复发和转移的特异性、准确性、阳性预测值和阴性预测值分别为83.3%(10/12)、87.0%(107/123)、98.0%(97/99)和41.7%(10/24).9例高分化肝细胞癌患者均确诊为肿瘤复发和(或)转移,18F-FDG PET/CT显像诊断其肿瘤复发和(或)转移5例,灵敏度(5/9)明显低于总体灵敏度(87.4%;χ2=6.616,P=0.01).结论 18F-FDG PET/CT显像在检测原发性肝癌治疗后AFP升高患者肿瘤复发和(或)转移病灶中有较好的应用价值,但高分化肝细胞癌可能出现假阴性.
목적 탐토18F-탈양포도당(FDG)PET/CT검측간암치료후갑태단백(AFP)승고환자종류복발화(혹)전이병조적개치.방법 원발성간세포암치료후혈청AFP승고환자123례,개행전신18F-FDG PET/CT현상.소유도상경도상융합후,진행PET/CT융합도상、PET도상화CT도상정대정대비분석.종류복발화(혹)전이병조근거병리검사결과、다충영상학진단급림상수방이학진.수방시간균>6개월.채용SPSS 11.5연건진행통계학처리,진행X2검험.결과 123례환자중,명학진단종류복발화(혹)전이자111례.18F-FDG PET현상진단종류복발화(혹)전이78례,기령민도위70.3%(78/111);18F.FDG PET/CT현상진단종류복발화(혹)전이97례,령민도제고지87.4%(97/111,χ2=9.744,P=0.002).18F.FDG PET/CT진단간암복발화전이적특이성、준학성、양성예측치화음성예측치분별위83.3%(10/12)、87.0%(107/123)、98.0%(97/99)화41.7%(10/24).9례고분화간세포암환자균학진위종류복발화(혹)전이,18F-FDG PET/CT현상진단기종류복발화(혹)전이5례,령민도(5/9)명현저우총체령민도(87.4%;χ2=6.616,P=0.01).결론 18F-FDG PET/CT현상재검측원발성간암치료후AFP승고환자종류복발화(혹)전이병조중유교호적응용개치,단고분화간세포암가능출현가음성.
Objective The aim of this study was to evaluate the clinical role of 18F-fluorodeoxyglucose (FDG) PET/CT for detection of recurrent and (or) metastatic tumor in patients with rising serum alpha fetoprotein (AFP) after the management of hepatocellular carcinoma (HCC). Methods The whole body 18F-FDG PET/CT scans were performed in 123 patients with rising serum AFP [(3554.49±1663.08) μg/L; normal level: 0-8.1 μg/L] on routine follow-up examinations after the management of HCC. All PET and CT images of one patient were fused by the specific software on workstation. PET images, CT images and PET/CT fused images were analyzed by frame to frame. All patients were followed up for more than six months. The final diagnosis was obtained by pathologic finding from surgery or biopsy, and (or) multi-modalities of imaging and clinical follow-up. Chi-Square test for statistics was used with SSPS 11.5 software. Results There were 111 patients proved to be suffered with recurrent and (or) metastatic tumor. Intrabepatic lesions were found in 84 patients; extrahepatic lesions were found in 65 patients. The overall sensitivity of 18F-FDG PET/CT for tumor detection was 87.4% (97/111) and it was obviously higher than 70.3%(78/111) of 18F-FDG PET alone (χ2= 9.744, P = 0.002). The specificity, accuracy, positive predictive value and negative predictive value of 18F-FDG PET/CT was 83.3% (10/12), 87.0% (107/123), 98.0%(97/99) and 41.7% (10/24), respectively. The PET and CT were complement in the lesions detection.In 9 patients proved as well-differentiated HCC, the sensitivity of 18F-FDG PET/CT was 5/9, which was lower than that of overall sensitivity (χ2 = 6.616, P = 0.01). Conclusions 18 F-FDG PET/CT is a valuable imaging tool to detect the recurrent and (or) metastatic tumor in patients with rising serum AFP after HCC treatment. Nevertheless, a pitfall of false-negative could be happened in patients with well-differentiated HCC.