CAJ | 학술논문

目的：18 F-脱氧葡萄糖（18 F fluorodeoxyglucose ，18 FDG） PET／CT对胃癌的诊断敏感性及特异性不佳。文中旨在探讨18 F PET／CT对低分化胃腺癌的诊断价值。方法回顾性分析第二军医大学附属长征医院2012年4月至2014年7月经手术或胃镜病理证实为低分化胃腺癌的34例患者18 FDG PET／CT征象，记录肿瘤大小、位置、胃壁浸润深度及最大标准摄取值（ maximum standardized uptake values ， SUVmax）。分析18 FDG摄取阳性与各个临床病理参数关系。结果34例患者低分化胃腺癌诊断阳性率仅为67．6％（23／34）。肿瘤大小、胃壁浸润深度与18FDG 摄取阳性率差异有统计学意义（P＜0．05）。性别、肿瘤位置、肿瘤病理亚型、淋巴结转移、远处转移与18FDG摄取阳性差异无统计学意义（P＞0．05）。根据二项分类Logistic回归分析表明肿瘤大小是低分化腺癌18FDG摄取的独立影响因素[OR＝0．37，95％CI（0．154，0．920）， P＝0．03]。结论18 FDG PET／CT对低分化胃腺癌的诊断价值有限，诊断时应警惕假阴性结果的出现。
목적：18 F-탈양포도당（18 F fluorodeoxyglucose ，18 FDG） PET／CT대위암적진단민감성급특이성불가。문중지재탐토18 F PET／CT대저분화위선암적진단개치。방법회고성분석제이군의대학부속장정의원2012년4월지2014년7월경수술혹위경병리증실위저분화위선암적34례환자18 FDG PET／CT정상，기록종류대소、위치、위벽침윤심도급최대표준섭취치（ maximum standardized uptake values ， SUVmax）。분석18 FDG섭취양성여각개림상병리삼수관계。결과34례환자저분화위선암진단양성솔부위67．6％（23／34）。종류대소、위벽침윤심도여18FDG 섭취양성솔차이유통계학의의（P＜0．05）。성별、종류위치、종류병리아형、림파결전이、원처전이여18FDG섭취양성차이무통계학의의（P＞0．05）。근거이항분류Logistic회귀분석표명종류대소시저분화선암18FDG섭취적독립영향인소[OR＝0．37，95％CI（0．154，0．920）， P＝0．03]。결론18 FDG PET／CT대저분화위선암적진단개치유한，진단시응경척가음성결과적출현。
Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P<0.05), but not with gender , tumor location , tumor pathologic subtype , lymph node metastasis , and distant metastasis ( P>0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .