CAJ | 학술논문

目的评价18 F-FLT联合18F-FDG PET/CT显像对胃癌原发灶及区域淋巴结转移的诊断价值.方法回顾性分析2011年3月至2013年4月间37例经活组织检查证实的胃癌患者临床资料.所有患者术前均行18F-FLT和18F-FDG双显像剂PET/CT检查,对显像结果分别进行视觉分析和半定量分析.应用SPSS 13.0软件分别对不同病理类型原发灶的SUVmax进行两样本t检验,对2种显像方法诊断效能的比较行x2检验.结果 18F-FLT和18F-FDG PET/CT诊断胃癌原发灶的灵敏度分别为89.2％ (33/37)和91.9％ (34/37),差异无统计学意义(x2=0.158,P＞0.05).弥漫型胃癌的18F-FLTSUVmax为6.89±1.38,与肠型胃癌的3.79±2.45差异有统计学意义(t=4.533,P＜0.05);而两者的18F-FDG SUVmax差异无统计学意义(7.13±1.97与6.36±2.32,t=1.066,P＞0.05).18 F-FLT和18 F-FDGPET/CT对胃癌区域淋巴结转移诊断的灵敏度、特异性、准确性分别为64.8％ (35/54)、97.6％(246/252)、91.8％(281/306)和88.9％ (48/54)、82.9％ (209/252)、84.0％ (257/306),差异均有统计学意义(x2=8.796、30.948、8.854,均P＜0.05);两者联合,灵敏度、特异性、准确性分别提高至92.6％(50/54)、98.8％ (249/252)、97.7％ (299/306).结论 18F-FLT是18F-FDG摄取少或不摄取的弥漫型胃癌的补充显像剂;对于胃癌转移淋巴结,18F-FLT比18F-FDG有更高的特异性和准确性,但灵敏度较低,两者联合可提高诊断准确性.
목적 평개18 F-FLT연합18F-FDG PET/CT현상대위암원발조급구역림파결전이적진단개치.방법 회고성분석2011년3월지2013년4월간37례경활조직검사증실적위암환자림상자료.소유환자술전균행18F-FLT화18F-FDG쌍현상제PET/CT검사,대현상결과분별진행시각분석화반정량분석.응용SPSS 13.0연건분별대불동병리류형원발조적SUVmax진행량양본t검험,대2충현상방법진단효능적비교행x2검험.결과 18F-FLT화18F-FDG PET/CT진단위암원발조적령민도분별위89.2％ (33/37)화91.9％ (34/37),차이무통계학의의(x2=0.158,P＞0.05).미만형위암적18F-FLTSUVmax위6.89±1.38,여장형위암적3.79±2.45차이유통계학의의(t=4.533,P＜0.05);이량자적18F-FDG SUVmax차이무통계학의의(7.13±1.97여6.36±2.32,t=1.066,P＞0.05).18 F-FLT화18 F-FDGPET/CT대위암구역림파결전이진단적령민도、특이성、준학성분별위64.8％ (35/54)、97.6％(246/252)、91.8％(281/306)화88.9％ (48/54)、82.9％ (209/252)、84.0％ (257/306),차이균유통계학의의(x2=8.796、30.948、8.854,균P＜0.05);량자연합,령민도、특이성、준학성분별제고지92.6％(50/54)、98.8％ (249/252)、97.7％ (299/306).결론 18F-FLT시18F-FDG섭취소혹불섭취적미만형위암적보충현상제;대우위암전이림파결,18F-FLT비18F-FDG유경고적특이성화준학성,단령민도교저,량자연합가제고진단준학성.
Objective To evaluate the value of 18F-FDG and 18F-FLT PET/CT for the detection of primary and regional lymph node metastasis of gastric cancer.Methods Thirty-seven patients with gastric cancer underwent preoperative 18F-FLT and 18F-FDG PET/CT within one week from March 2011 to April 2013.Postoperative histopathology confirmation was obtained in all patients.The PET/CT images were assessed visually and semi-quantitatively.Two-sample t and x2 tests were analyzed using SPSS 13.0.Results For the detection of primary gastric cancer,the sensitivities of 18 F-FLT and 18 F-FDG PET were 89.2％ (33/ 37) vs 91.9％(34/37),respectively (x2=0.158,P＞0.05).The 18F-FLT SUVmax of 16/37 cases with diffuse-type gastric cancer was significantly higher than that of 21/37 cases with intestinal-type gastric cancer (6.89±1.38 vs 3.79±2.45,t=4.533,P＜0.05) ; while 18F-FDG SUVmaxwas not significantly different between the two subgroups (7.13± 1.97 vs 6.36±2.32,t =1.066,P＞0.05).For the detection of regional lymph node metastasis,the sensitivity,specificity and accuracy of 18F-FLT and 18F-FDG were 64.8％(35/54) vs 88.9％(48/54),97.6％(246/252) vs 82.9％(209/252),91.8％(281/306) vs 84.0％(257/306),respectively (x2 =8.796,30.948,8.854,all P＜0.05).The overall sensitivity,specificity and accuracy by both tracers were 92.6％(50/54),98.8％(249/252) and 97.7％(299/306).Conclusions 18F-FLT might be a better or complementary tracer to 18F-FDG for the detection of diffuse-type gastric cancer.Compared with 18FFDG PET/CT,18F-FLT PET/CT may be less sensitive but more specific and accurate for the detection of regional lymph node metastasis.The overall diagnostic accuracy can be improved by using both tracers.