18F-FDG PET/CT全身显像在原发灶不明转移癌中的临床应用 |
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引用本文: | 王国慧,梁培炎,蔡燕君,张伟光,谢传淼,吴沛宏. 18F-FDG PET/CT全身显像在原发灶不明转移癌中的临床应用[J]. 中华核医学杂志, 2008, 28(6) |
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作者姓名: | 王国慧 梁培炎 蔡燕君 张伟光 谢传淼 吴沛宏 |
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作者单位: | 1. 华南肿瘤学国家重点实验室、中山大学肿瘤防治中心影像介入科,广州,510060 2. 2510060,广州,华南肿瘤学国家重点实验室、中山大学肿瘤防治中心核医学科 |
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摘 要: | 目的 探讨18F-脱氧葡萄糖(FDG)PET/CT全身显像在原发灶不明转移癌(CUP)诊断中的临床应用价值.方法 回顾性分析2006年1月至2007年6月2589例18F-FDG PET/CT显像患者中169例CUP患者的显像结果,通过分析病历记录、病理检查结果及临床随访确定最终原发灶诊断结果.结果 169例CUP患者中19例失访,150例有完整资料.70例成功探测到原发灶,总检出率为46.7%(70/150),其中52例得到病理检查证实,18例为临床诊断;肺癌38例,占54.3%,鼻咽癌8例,占11.4%,消化系统肿瘤13例,占18.6%,其他肿瘤11例,占15.7%.3例临床怀疑转移瘤,18F-FDG PET/CT未见明显恶性征象,经随访证实为良性病变.6例PET/CT诊断错误.15例患者没有确诊.56例未探测到原发灶,其中3例在随访过程中得到确诊,分别为鼻咽癌、膀胱癌、食管癌各1例.结论 18F-FDG PET/CT全身显像对诊断CUP具有重要临床价值.
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关 键 词: | 肿瘤转移 体层摄影术,发射型计算机 体层摄影术,x线计算机 脱氧葡萄糖 |
Clinical study of 18F-FDG PET/CT whole-body imaging in disseminated carcinoma of unknown primary site |
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Abstract: | Objective Carcinoma of unknown primary (CUP) is not uncommon in usual clinical settings. They are, by definition, those cases with clinically suspected primary malignancy but not revealed by conventional investigation. The aim of this study was to investigate the efficacy of whole-body 18F-fluoro-deoxyglucose (FDG) PET/CT in detecting a primary neoplasm for these patients. Methods A totle of 150patients with retrievable records from 169 CUP patients were selected within a group of consecutive 2589 pa-tients from Jan. 2006 to Jun. 2007. All cases underwent whole-body FDG PET/CT scan. The final diagno-ses were confirmed by pathologic results, other imaging modalities or clinical follow-up. Results Among 150 patients, primary tumor sites were successfully detected by whole-body ,s F-FDG PET/CT scan in 70 ca-ses (46.7%), of which 52 were pathologically confirmed and 18 by clinical follow-up. And 38 cases (54.3%) were lung cancer, 8 (11.4%) were nasopharyugeal carcinoma, 13(18.6%) in digestive sys-tem, and 11 (15.7%) in other systems. Three clinically suspected CUP cases with negative 18F-FDG PET/CT were subsequently confirmed of benign processes by clinical follow-up. Six patients were wrongly diag-nosed by 18F-FDG PET/CT, and 15 patients did not have a confirmed diagnosis by the end of research. The primary cause of malignancy after 18F-FDG PET/CT remained obscure in 56 patients, only 3 of whom be-came known during the course of clinical follow-up (nasopharyngeal bladder and esophageal carcinoma).Conclusion 18F-FDG PET/CT whole-body imaging plays an important role in patients with metastatic CUP. |
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Keywords: | Neoplasm metastasis Tomography,emission-computed Tomograpliy,X-ray computed Deoxyglucose |
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