CAJ | 학술논문

目的：回顾性分析食管鳞癌术后复发转移病例的18F-脱氧葡萄糖(18F-FDG)PET/CT影像特点，探讨PET/CT监测食管癌复发转移的临床应用价值。方法：收集2009年12月—2014年12月食管鳞癌术后于本院行18F-FDG PET/CT检查的病例，对166例有复发和(或)转移的病例分析其复发或转移部位、频数及代谢程度。结果：166例患者中，局部复发45例，80%为吻合口原位复发，最大标准摄取值(SUVmax)与病灶厚度无明显相关性(P＞0.05)。149例转移病例中，单纯淋巴结转移占72.5%、单纯血行转移占4.7%、混合转移占22.8%。淋巴结转移以纵隔(66.8%)、锁骨上(39.2%)、腹膜后(21.1%)、腹腔(11.4%)为多，少数出现肺门、盆腔、颈部、腋窝、内乳区淋巴结转移。血行转移以骨、肺、肝、胸膜为主，少数伴有肌肉、腹膜、脑、脾、心包、肾上腺转移。PET/CT可检出小于1.0 cm的转移淋巴结(57例)，淋巴结短径大于等于1.0 cm组与小于1.0 cm组的SUVmax差异有统计学意义(P＜0.01)，SUVmax与淋巴结大小无明显相关性(P＞0.05)。结论：食管鳞癌术后复发以吻合口局部为主，转移以淋巴结为主，少数为血行转移。PET/CT易检出复发转移病灶，在探测小于1.0 cm淋巴结转移、非常见部位淋巴结转移、远处血行转移方面独具优势。
목적：회고성분석식관린암술후복발전이병례적18F-탈양포도당(18F-FDG)PET/CT영상특점，탐토PET/CT감측식관암복발전이적림상응용개치。방법：수집2009년12월—2014년12월식관린암술후우본원행18F-FDG PET/CT검사적병례，대166례유복발화(혹)전이적병례분석기복발혹전이부위、빈수급대사정도。결과：166례환자중，국부복발45례，80%위문합구원위복발，최대표준섭취치(SUVmax)여병조후도무명현상관성(P＞0.05)。149례전이병례중，단순림파결전이점72.5%、단순혈행전이점4.7%、혼합전이점22.8%。림파결전이이종격(66.8%)、쇄골상(39.2%)、복막후(21.1%)、복강(11.4%)위다，소수출현폐문、분강、경부、액와、내유구림파결전이。혈행전이이골、폐、간、흉막위주，소수반유기육、복막、뇌、비、심포、신상선전이。PET/CT가검출소우1.0 cm적전이림파결(57례)，림파결단경대우등우1.0 cm조여소우1.0 cm조적SUVmax차이유통계학의의(P＜0.01)，SUVmax여림파결대소무명현상관성(P＞0.05)。결론：식관린암술후복발이문합구국부위주，전이이림파결위주，소수위혈행전이。PET/CT역검출복발전이병조，재탐측소우1.0 cm림파결전이、비상견부위림파결전이、원처혈행전이방면독구우세。
Objective:To investigate the application value of18F-fluorodeoxyglucose (18F-FDG) PET/CT in detecting postoperative recurrence and metastasis of esophageal carcinoma.Methods:From December 2009 to December 2014, a total of 300 patients with curative resection of the esophageal carcinoma underwent PET/CT examination in our hospital. Of these patients, 166 cases diagnosed with recurrence or metastasis were enrolled in the study.Results:Among the 166 cases, local recurrence was foundin 45 patients, 80% with anastomotic recurrencein situ. The maximal standardized uptake value (SUVmax) was not correlated with lesion thickness. Among 149 metastatic cases, 72.5% had simple lymph node metastasis, 4.7% had simple hematogenous metastasis, and 22.8% had lymph node metastasis and hematogenous metastasis.18F-FDG PET/CT detected 57 cases with metastatic lymph node within 1.0 cm. There was no signiifcance in SUVmax between metastatic lymph node <1.0 cm group and metastatic lymph node≥1.0 cm group. SUVmax was not correlated with lymph node diameter.Conclusion:The postoperative recurrence of esophageal carcinoma is usually localized at anastomotic site, and lymph node metastasis is common.18F-FDG PET/CT is one optional method for diagnosis of recurrence and metastasis after curative resection of esophageal carcinoma. It plays an outstanding role in detecting lymph node (<1.0 cm) metastasis, uncommon lymph node metastasis and distant hematogenous metastasis.