国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2011年
5期
269-274
,共6页
胃肿瘤%肿瘤复发,局部%肿瘤转移%体层摄影术,发射型计算机,单光子%体层摄影术,X线计算机%氟脱氧葡萄糖F18
胃腫瘤%腫瘤複髮,跼部%腫瘤轉移%體層攝影術,髮射型計算機,單光子%體層攝影術,X線計算機%氟脫氧葡萄糖F18
위종류%종류복발,국부%종류전이%체층섭영술,발사형계산궤,단광자%체층섭영술,X선계산궤%불탈양포도당F18
Stomach neoplasms%Neoplasm recurrence,local%Neoplasm metastasis%Tomography,emission-computed,single-photon%Tomography,X-ray computed%Fluorodeoxyglucose F18
目的 探讨18F-FDG SPECT-CT在监测胃癌术后复发及转移中的临床价值.方法 回顾性分析122例胃癌术后患者的SPECT-CT显像资料,结合再次病理检查结果,其中79例与同期增强CT检查及二者联合检查两两比较其在残胃或吻合口复发的诊断效能；109例与同期胃肿瘤标志物结果及二者联合检查两两比较其在评价转移灶的诊断效能.应用SPSS13.0软件进行卡方检验或Fisher精确检验.结果 ①18F-FDG SPECT-CT诊断残胃或吻合口复发的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为84.0％、96.3％、91.3％、92.9％及92.4％；同期增强CT为58.3％、78.2％、53.8％、81.1％及72.2％,其中前者的灵敏度、特异度、阳性预测值及准确率均显著高于增强CT( x2=3.953～11.805,P均＜0.05),阴性预测值虽然高于增强CT,但差异无统计学意义(x2=3.344,P＞0.05)；二者联合诊断的指标为:88.0％、98.1％、95.7％、94.6％及94.9％,显著高于增强CT( x2=4.732～10.341,P均＜0.05),二者联合诊断虽然也高于18F-FDG SPECT-CT,但差异均无统计学意义(x2均=0.000,P＞0.05).②18F-FDG SPECT-CT诊断胃癌术后转移的灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为92.9％、87.5％、96.3％、80.8％及91.7％；胃肿瘤标志物检测为81.2％、75.0％、92.0％、52.9％及79.8％,其中前者灵敏度、阴性预测值及准确率显著高于胃肿瘤标志物检测(x2=4.026～6.355,P均＜0.05),特异度与阳性预测值虽然也高于胃肿瘤标志物检测,但差异无统计学意义(x2=0.574,x2=0.681,P＞0.05)；二者联合诊断的指标分别为96.5％、83.3％、95.3％、87.0％及93.6％,与18F-FDG SPECT-CT大致相仿,且差异均无统计学意义(x2=4.026～6.355,P均＞0.05),但灵敏度、阴性预测值及准确率显著高于胃肿瘤标志物(x2=7.143～10.014,P均＜0.05).结论 18F-FDG SPECT-CT诊断胃癌术后复发及转移具有较大的临床价值.
目的 探討18F-FDG SPECT-CT在鑑測胃癌術後複髮及轉移中的臨床價值.方法 迴顧性分析122例胃癌術後患者的SPECT-CT顯像資料,結閤再次病理檢查結果,其中79例與同期增彊CT檢查及二者聯閤檢查兩兩比較其在殘胃或吻閤口複髮的診斷效能；109例與同期胃腫瘤標誌物結果及二者聯閤檢查兩兩比較其在評價轉移竈的診斷效能.應用SPSS13.0軟件進行卡方檢驗或Fisher精確檢驗.結果 ①18F-FDG SPECT-CT診斷殘胃或吻閤口複髮的靈敏度、特異度、暘性預測值、陰性預測值及準確率分彆為84.0％、96.3％、91.3％、92.9％及92.4％；同期增彊CT為58.3％、78.2％、53.8％、81.1％及72.2％,其中前者的靈敏度、特異度、暘性預測值及準確率均顯著高于增彊CT( x2=3.953～11.805,P均＜0.05),陰性預測值雖然高于增彊CT,但差異無統計學意義(x2=3.344,P＞0.05)；二者聯閤診斷的指標為:88.0％、98.1％、95.7％、94.6％及94.9％,顯著高于增彊CT( x2=4.732～10.341,P均＜0.05),二者聯閤診斷雖然也高于18F-FDG SPECT-CT,但差異均無統計學意義(x2均=0.000,P＞0.05).②18F-FDG SPECT-CT診斷胃癌術後轉移的靈敏度、特異度、暘性預測值、陰性預測值及準確率分彆為92.9％、87.5％、96.3％、80.8％及91.7％；胃腫瘤標誌物檢測為81.2％、75.0％、92.0％、52.9％及79.8％,其中前者靈敏度、陰性預測值及準確率顯著高于胃腫瘤標誌物檢測(x2=4.026～6.355,P均＜0.05),特異度與暘性預測值雖然也高于胃腫瘤標誌物檢測,但差異無統計學意義(x2=0.574,x2=0.681,P＞0.05)；二者聯閤診斷的指標分彆為96.5％、83.3％、95.3％、87.0％及93.6％,與18F-FDG SPECT-CT大緻相倣,且差異均無統計學意義(x2=4.026～6.355,P均＞0.05),但靈敏度、陰性預測值及準確率顯著高于胃腫瘤標誌物(x2=7.143～10.014,P均＜0.05).結論 18F-FDG SPECT-CT診斷胃癌術後複髮及轉移具有較大的臨床價值.
목적 탐토18F-FDG SPECT-CT재감측위암술후복발급전이중적림상개치.방법 회고성분석122례위암술후환자적SPECT-CT현상자료,결합재차병리검사결과,기중79례여동기증강CT검사급이자연합검사량량비교기재잔위혹문합구복발적진단효능；109례여동기위종류표지물결과급이자연합검사량량비교기재평개전이조적진단효능.응용SPSS13.0연건진행잡방검험혹Fisher정학검험.결과 ①18F-FDG SPECT-CT진단잔위혹문합구복발적령민도、특이도、양성예측치、음성예측치급준학솔분별위84.0％、96.3％、91.3％、92.9％급92.4％；동기증강CT위58.3％、78.2％、53.8％、81.1％급72.2％,기중전자적령민도、특이도、양성예측치급준학솔균현저고우증강CT( x2=3.953～11.805,P균＜0.05),음성예측치수연고우증강CT,단차이무통계학의의(x2=3.344,P＞0.05)；이자연합진단적지표위:88.0％、98.1％、95.7％、94.6％급94.9％,현저고우증강CT( x2=4.732～10.341,P균＜0.05),이자연합진단수연야고우18F-FDG SPECT-CT,단차이균무통계학의의(x2균=0.000,P＞0.05).②18F-FDG SPECT-CT진단위암술후전이적령민도、특이도、양성예측치、음성예측치급준학솔분별위92.9％、87.5％、96.3％、80.8％급91.7％；위종류표지물검측위81.2％、75.0％、92.0％、52.9％급79.8％,기중전자령민도、음성예측치급준학솔현저고우위종류표지물검측(x2=4.026～6.355,P균＜0.05),특이도여양성예측치수연야고우위종류표지물검측,단차이무통계학의의(x2=0.574,x2=0.681,P＞0.05)；이자연합진단적지표분별위96.5％、83.3％、95.3％、87.0％급93.6％,여18F-FDG SPECT-CT대치상방,차차이균무통계학의의(x2=4.026～6.355,P균＞0.05),단령민도、음성예측치급준학솔현저고우위종류표지물(x2=7.143～10.014,P균＜0.05).결론 18F-FDG SPECT-CT진단위암술후복발급전이구유교대적림상개치.
Objective To evaluate the clinical value of 18F-FDG SPECT-CT in detecting recurrence and metastasis of gastric cancer.Methods Analyzed the SPECT-CT imaging data in 122 cases with gastric cancer retrospectively,and then combined with the results of pathological examination,of which 79 cases compared with the same period of enhanced CT and the joint inspection of the two by each other in the remnant stomach or anastomotic recurrence of diagnostic performance; 109 cases with the comparison of stomach tumor markers and the joint inspection of the two by each other in the diagnosis of metastatic evaluation of performance.SPSS13.0 software package was used to performx2 test and fisher's exact probability.Results ① The sensitivity,specificity,positivity predicitive value (PPV),negative predictive value (NPV),and accuracy of 18F-FDG SPECT-CT in diagnosing residual stomach or anastomotic recurrence was 84.0％,96.3％,91.3％,92.9％ and 92.4％ respectively.Those of enhanced CT was 58.3％,78.2％,53.8％,81.1％ and 72.2％ respectively.The former of which the sensitivity,specificity,PPV and accuracy were significantly higher than enhanced CT,and the difference was statistically significant (χ2=3.953～11.805,all P＜0.05).Although the NPV is higher than enhanced CT,the difference was not statistically significant (χ2=3.344,P＞0.05).Joint diagnosis of the two indicators was 88.0％,98.1％,95.7％,94.6％ and 94.9％ respectively,significantly higher than the enhanced CT,and the difference was statistically significance (x2=4.732～10.341,all P＜0.05).Although the indicators were higher than 18F-FDG SPECT-CT,the difference was not statistically significant (allχ2=0.000,P＞0.05).② The sensitivity,specificity,PPV,NPV,and accuracy of 18F-FDG SPECT-CT in diagnosing metastasis of gastric cancer was 92.9％,87.5％,96.3％,80.8％ and 91.7％ respectively.Those of gastric tumor markers was 81.2％,75.0％,92.0％,52.9％ and 79.8％.Where the former sensitivity,NPV and accuracy were significantly higher than the stomach tumor markers,the difference was statistically significant(χ2=4.026～6.355,all P＜0.05).Although specificity and PPV were higher than the gastric tumor markers,the difference was not statistically significant (χ2=0.574,0.681,P＞0.05).The two combined diagnostic indicators was 96.5％,83.3％,95.3％,87.0％ and 93.6％ respectively,similarly with the 18F-FDG SPECT-CT,and the difference was not statistically significant(χ2=4.026～6.355,all P＞0.05),but significantly higher than the gastric tumor markers,and the sensitivity,NPV and accuracy of the difference was statistically significant (χ2=7.143～10.014,all P＜0.05).Conclusion 18F-FDG SPECT-CT has greater clinical value in detecting recurrence and metastasis of gastric cancer.
