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1.
目的评价^18FDG—PET诊断卵巢癌治疗后复发的价值。方法对54例临床疑有复发的卵巢癌患者进行了^18FDG—PET全身及腹部成像、CT、血清CA125检测,并对结果进行分析比较。结果54例临床疑有复发的卵巢癌患者中,病理组织学证实肿瘤复发35例。^18FDG—PET检查39/54例显示阳性;CT常规影像检查28/54例阳性;29/54例血清CA125升高。PET、CT、及血清CA125监测卵巢癌复发和转移的灵敏度、特异性和准确性分别为100.00%、78.95%和92.59%;74.29%、89.47%和79.63%;80.oo%、94.74%和85.19%。PET对检测卵巢癌复发和转移诊断的阳性率高于血清CA125和CT。PET—CT联合、PET联合CA125、CT联合CA125、PET—CT联合CA125监测卵巢癌复发和转移的灵敏度、特异性和准确性分别为100.00%、73.68%和90.74%;100.00%、73.68%和90.74%;80.00%、89.47%和83.33%;100.00%、68.42%和88.89%。结论^18FDG—PET全身显像作为无创伤性检查技术,能及时探测到复发或扩散肿瘤的代谢变化,可以为卵巢癌术后随访提供一种有效的非侵入性影像学诊断方法。  相似文献   

2.
目的:探讨PET/CT在监测卵巢癌术后复发、转移中的应用价值.方法:回顾性分析20例卵巢癌术后患者全身18F-FDG PET/CT显像结果,临床随访时间6~18个月.确诊依据为手术病理检查、穿刺活检、多种影像学检查和临床随诊.结果:20例患者中,13例(65%)患者最终确定有复发或转移,PET/CT诊断复发转移病例的灵敏度为100.0%,特异性为85.7%、准确性为95.0%.13例患者病理或随访确诊32处病灶, PET/CT共发现29处阳性病灶.PET/CT诊断复发或转移灶的灵敏度、特异性、准确率、阳性预测值及阴性预测值分别为84.3%(27/32)、81.8%(9/11)、83.7%(36/43)、93.1%(27/29)和64.2%(9/14).20例患者中,11例肿瘤标志CA125升高, 10例PET/CT检查显示复发或转移病灶,并经最终结果证实,1例血清CA125水平升高但PET/CT未检出转移灶,至随访结束未发现复发或转移.另有3例血清CA125水平正常,但PET/CT检查发现转移灶.结论:18F-FDG PET/CT检查诊断卵巢癌术后复发转移灵敏度、特异性和准确率较高,在卵巢癌术后监测中有重要作用.  相似文献   

3.
目的:探讨18F-脱氧葡萄糖(18F-FDG)PET/CT在早期发现卵巢癌术后复发/转移方面的价值,并与血清CA125检测及增强CT进行比较。方法:回顾性分析过去5年内在我院行卵巢癌二次手术,并在术前均行血清CA125、增强CT、PET/CT检查的患者36例(99个病灶)。分别计算出以患者个体为研究单位时血清CA125及PET/CT检查的阳性预测值、阴性预测值、灵敏度、特异度、准确度等参数,并比较二者在监测卵巢癌术后个体复发/转移方面的效能。采用卡方检验或Fisher确切概率法来比较增强CT、PET/CT两种方法诊断卵巢癌术后转移/复发病灶的差异性,并分别计算出以病灶为研究单位时的阳性预测值、阴性预测值、灵敏度、特异度、准确度等参数,比较二者在诊断卵巢癌术后复发/转移病灶方面的效能。结果:PET/CT诊断出34/36例复发/转移的患者,而血清CA125以0~35 U/ml为基准时仅诊断出11/36例复发/转移的患者。前者诊断卵巢癌术后复发/转移患者的阳性预测值、灵敏度、准确度明显高于后者(97%、100%、97% vs 91%、32%、33%)。PET/CT与增强CT在诊断卵巢癌术后复发/转移病灶效能方面差异具有统计学意义(P=0.037)。PET/CT能够诊断出78/99个卵巢癌术后复发/转移的真阳性病灶,而增强CT仅能够诊断出70/99个。PET/CT以病灶为研究单位的阳性预测值、阴性预测值、灵敏度、特异度、准确度均比增强CT高(94% vs 89%、62.5% vs 30%、93% vs 83%、67% vs 40%、89% vs 77%)。结论:对于符合二次手术条件的患者,PET/CT诊断卵巢癌术后复发/转移方面的价值要优于血清CA125及增强CT。  相似文献   

4.
18F-FDG联合99mTc-MDP显像在乳腺癌术后随访中的应用   总被引:1,自引:0,他引:1  
目的:探讨^18F—FDG符合探测显像联合^99mTc—MDP骨显像在乳腺癌手术化疗后早期随访中,监测其复发及转移的临床应用价值。方法:81例乳腺癌患者手术化疗后3年内,分别行^18F—FDG符合探测显像、^99mTc—MDP骨显像、CT显像,计算灵敏度、特异性、准确性。结果:81例乳腺癌手术化疗后患者中,经病理检查或临床及其他影像学诊断转移31例,^18F—FDG符合探测显像对复发及转移患者监测的灵敏度、特异性、准确性分别为74.2%、92.0%、85.2%;CT显像对复发及转移患者监测的灵敏度、特异性、准确性分别为58.1%、88.0%、76.5%;^18F—FDG符合探测显像联合^99mTc—MDP骨显像诊断对复发及转移患者监测的灵敏度、特异性、准确性分别为93.5%、92.0%、92.6%。结论:^18F—FDG符合探测显像联合^99mTc—MDP骨显像对乳腺癌手术化疗后患者的早期随访中,灵敏度、特异性、准确性均较高。对监测其复发及转移具有重要的临床应用价值。  相似文献   

5.
18FDG-PET显像在监测卵巢癌复发和转移中的作用   总被引:1,自引:0,他引:1  
目的 评价18FDG-PET诊断卵巢癌治疗后复发的价值.方法 对54例临床疑有复发的卵巢癌患者进行了18FDG-PET全身及腹部成像,并与CA125进行比较.结果 54例临床疑有复发的卵巢癌患者中,病理证实肿瘤复发35例.18FDG-PET检查39/54例显示阳性;29/54例血清CA125升高.PET、CA125监测卵巢癌复发和转移的灵敏度、特异性和准确性分别为100%、78.95%和92.59%;80%、94.74%和85.19%.结论 18FDG-PET全身显像作为无创伤性检查技术,能及时探测到复发或扩散肿瘤的代谢变化,可以为卵巢癌术后随访提供一种有效的非侵入性影像学诊断方法.  相似文献   

6.
[目的]探讨^18F-FDG PET/CT显像对原发性脑淋巴瘤的诊断价值。[方法]6例经病理学证实的脑原发性淋巴瘤患者(男性4例,女性2例)行^18F-FDG PET/CT检查.其中5例为初诊患者,1例为可疑复发的复诊患者。[结果]6例患者共8个病灶,其中基底节区5个,丘脑1个,额叶2个。肿瘤为单发或多发病灶,多位于脑组织深部,边界清楚,大小不等,圆形或卵圆形.周围水肿较轻。18F—FDGPET/CT显像病灶多表现为稍高密度灶,对18F—FDG摄取明显增高。『结论]原发性脑淋巴瘤的18F—FDGPET/CT表现有一定特征性,熟悉其影像特点有助于作出正确的诊断。  相似文献   

7.
[目的]比较^18F-FDG PET/CT显像与双侧髂棘穿刺活检在弥漫大B细胞淋巴瘤(DL—BCL)骨髓浸润的诊断价值。[方法]收集我中心2005年7月~2007年6月81例初诊DLBCL患者,所有患者均行^18F-FDG PET/CT显像及双侧髂棘穿刺活检,其中9例患者PET/CT指导下行其它部位骨髓FDG高代谢灶穿刺活检。[结果]81例初诊DLBCL患者中,共20例确诊伴有骨髓浸润。^18F-FDG PET/CT显像见23例骨髓代谢活跃灶,其中17例病理确诊骨髓浸润;双侧髂棘穿刺活检11例患者确诊骨髓浸润。^18F-FDG PET/CT显像诊断骨髓浸润的阳性率为85%(17/20),双侧髂棘穿刺活检诊断骨髓浸润的阳性率为55%(11/20),差异有显著性(P〈0.05)。[结论]^18F—FDG PET/CT显像可以全面评价骨髓状况,较双侧髂棘穿刺活检能发现更多的骨髓浸润患者和更多的病灶;在骨髓代谢活跃部位穿刺活检,可提高穿刺的准确率。  相似文献   

8.
18F-FDG PET/CT显像在胃癌诊断中的应用   总被引:1,自引:1,他引:0  
周海中  于明明  段钰 《肿瘤学杂志》2012,18(10):738-739
[目的]评价18F-FDG PET/CT显像在胃癌诊断中的应用.[方法]49例经胃镜和病理确诊的胃癌患者进行18F-FDG PET/CT显像,其诊断结果与病理学检查、其他影像学检查及临床随访比较.[结果] 49例患者18F-FDG PET/CT阳性44例,阳性率89.8%;39例有淋巴结转移患者中18F-FDGPET/CT显像发现32例,灵敏度为82.1%(32/39); 12例有远处转移患者中18F-FDG PET/CT显像发现11例,灵敏度91.6%(11/12).[结论]18F-FDG PET/CT显像对胃癌原发灶、淋巴结转移和远处转移具有较高的灵敏度,18F-FDG PET/CT显像在胃癌诊断中具有较高的临床价值.  相似文献   

9.
[目的]探讨^18F-氟代脱氧葡萄糖(2-deoxy-2-[F-18]fluoro-D-gluocose,FDG)符合线路SPECT/CT显像在寻找肿瘤原发灶中的价值。[方法]35例原发灶不明的转移瘤患者行^18F-FDG符合线路SPECT/CT显像寻找原发灶。[结果]21例患者符合线路SPECT/CT显像发现可疑原发灶,其中16例被其他影像学检查、活检或手术病理证实,对原发灶的检出率为45.7%(16/35例),14例未能明确原发灶。^18F-FDG符合线路显像发现其他影像学手段未发现的新病灶13个,8例改变治疗方案。[结论]^18F-FDG符合线路SPECT/CT显像在寻找转移性肿瘤原发灶有较大的临床价值。  相似文献   

10.
目的探讨^18F—FDG符合线路SPECT显像在探测胃肠道恶性肿瘤术后复发和远处转移中的应用价值。方法24例胃肠道恶性肿瘤术后患者,其中食管癌4例,胃癌7例,结肠癌6例,直肠癌7例,运用SIEMENS ECAM^deut SPECT仪进行^18F—FDG显像。结果^18F—FDG显像诊断胃肠道恶性肿瘤术后转移和复发的灵敏度为94.7%,特异性80.0%,准确性91.7%。在^18F—FDG显像真阳性18例中,2例为局部复发,5例为局部复发伴转移,11例为远处转移。在有复发的7例患者中,5例^18F—FDG显像结果与CT检查结果一致,2例CT检查局部未见异常,在有转移的16例患者中,共检出转移灶55处。结论符合线路SPECT仪^18F—FDG显像是检测胃肠道恶性肿瘤术后复发和转移的敏感而有效的方法。  相似文献   

11.
AIM: Many patients with ovarian cancer are at high risk of recurrence especially in the 2 years following first-line therapy. CA125 serum levels measurement associated to computed tomography (CT), ultrasound (US) and magnetic resonance imaging (MRI) are currently used during follow-up to detect recurrent disease. Unfortunately, in a relevant percentage of cases all of these traditional imaging techniques provide a significant number of doubtful/equivocal results or turn out negative even in presence of elevated Ca125 levels. Aim of our study was to evaluate sensitivity, specificity and accuracy of (18)F-FDG PET/CT in a group of patients with suspicion of ovarian cancer recurrence. METHODS: We prospectively evaluated 41 patients with a mean age of 59.4 years who had been previously treated for ovarian cancer with surgery and radio-chemotherapy or radio-chemotherapy alone. Following the performance of traditional radiologic imaging (US, CT, MRI) and Ca125 measurement, all patients underwent additional (18)F-FDG PET/CT. PET/CT results were compared with histologic findings or clinical, laboratory and repeated traditional imaging techniques during subsequent follow-up data. RESULTS: Of 41 patients 32 had a positive PET-CT (30 true positive, two false positive) whereas nine a negative PET/CT (five true negative, four false negative). Overall, in our experience (18)F-FDG PET/CT provided a good sensitivity (88.2%), specificity (71.4%) and accuracy (85.4%), superior to that reported in literature for traditional radiologic imaging. CONCLUSIONS: It can be concluded that (18)F-FDG PET/CT appears to be a useful and accurate tool in disclosing early recurrent ovarian cancer.  相似文献   

12.
Although many cancers can be detected by whole-body positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (FDG), there has been limited clinical experience with FDG-PET for the detection of recurrent ovarian cancers. Therefore, the aim of this study was to evaluate the clinical value of FDG-PET in the detection of recurrent ovarian cancer. Whole body FDG-PET scans were performed on 24 women who had previous histories of ovarian cancer and treatment with surgery and chemotherapy. All patients also underwent physical examination, laboratory testing of serum CA-125 level and pelvic-abdominal-chest computed tomography (CT) or magnetic resonance imaging (MRI). The results of FDG-PET scans were correlated with serum CA-125 level, CT/MRI and operative pathology results. The diagnostic sensitivity was 90.9%, 90.9% and 90.9%, specificity was 92.3%, 76.9% and 46.2% and accuracy was 91.7%, 83.3% and 66.7% for FDG-PET, serum tumor marker of CA-125 level and CT/MRI in detecting recurrent ovarian cancer, respectively. FDG-PET is a useful diagnostic tool in detecting recurrent ovarian cancers with high specificity as compared with the serum tumor marker CA-125 level and the conventional CT/MRI morphological imaging methods.  相似文献   

13.
Objective: This study aimed to examine the diagnostic performance of F-18 fluorodeoxyglucose positron emission tomography with computed tomography (F-18 FDG PET/CT) compared with cancer antigen 125 (CA125), human epididymis protein 4 (HE4), and risk of ovarian malignancy algorithm (ROMA) score to distinguish epithelial ovarian cancer from benign tumors. Methods: A total of 46 patients with pelvic masses, who underwent F-18 FDG PET/CT, CA125, and HE4 before surgery between January 2015 and December 2018, were included in this retrospective study. The diagnostic performance of CA125, HE4, ROMA score, and maximum standardized uptake value (SUVmax) to differentiate epithelial ovarian cancer from benign pelvic tumors was examined by receiver operating characteristic curve analysis. Results: Among the 46 patients, 28 were cases of ovarian cancers and 18 were of benign. The mean values of CA125, HE4, ROMA score, and SUVmax were significantly higher in the ovarian cancer group than the benign group. In early cancer stages (stages I and II), Area under the curve for SUVmax was significantly higher than CA125 and ROMA score (0.778 for CA125, 0.753 for HE4, 0.682 for ROMA score, and 0.922 for SUVmax). Conclusion: SUVmax using F-18 FDG PET/CT showed a high diagnostic accuracy for differentiating epithelial ovarian cancer from benign pelvic tumors, including early stage ovarian cancer. F-18 FDG PET/CT can be a useful modality for the assessment of pelvic mass.  相似文献   

14.
目的 评价氟脱氧葡萄糖(FDG)PET-CT常规及双时相显像在监测食管癌术后复发转移中的应用价值.方法 回顾分析食管癌术后临床怀疑复发转移而行FDG PET-CT检查的48例患者临床资料,根据细胞学、病理或随访结果分析FDG PET-CT检查结果.两样本率比较采用Fisher's精确概率法检验.结果 48例患者中位随访21.5个月,34例出现复发转移,确定复发转移灶61处.FDG PET-CT常规显像对全部病灶诊断的敏感性、特异性和准确性分别为93.44%、74.29%和86.46%;对局部复发和区域淋巴结转移的敏感性、特异性、准确性分别为91.67%、57.14%、78.95%和90.48%、77.78%、84.62%.FDG PET-CT双时相显像诊断局部复发+区域淋巴结转移的敏感性、特异性、准确性均高于常规显像,分别为96.97%∶90.90%(P=0.613)、96.00%∶72.00%(P=0.049)、96.55%∶82.76%(P=0.029).结论 FDG PET-CT常规显像虽然检测食管癌术后局部复发及区域淋巴结转移的特异性和准确性较低,但仍是检测其术后复发转移的有效手段;双时相显像较常规显像更具优势,可有效提高检测的特异性及准确性.
Abstract:
Objective To evaluate the clinical value of regular and dual-time-point 18-fluorodeoxyglucose positron emission tomography-CT(FDG PET/CT)imaging for recurrence and metastasis in esophageal carcinoma(EC)after curative esophagectomy. Methods A retrospective study was done on 48 patients received curative esophagectomy, who underwent FDG PET/CT scans to detect doubtful recurrent or metastatic lesions. The diagnostic accuracy of FDG PET-CT was assessed with the help of pathological findings as well as clinical or follow-up data. Using Fisher's Exact Test from SPSS 11.5 to analyze the data.Results Of the 48 patients, after a median follow-up of 21.5 months, 61 sites of local and regional recurrence or metastasis were finally confirmed in 34 patients. The sensitivity, specificity and accuracy of regular FDG PET/CT imaging in detecting recurrence of all sites were 93.44%, 74.29% and 86.46%respectively. The specificity and accuracy of local recurrence and regional metastasis were 57.14% ,78.95% and 77.78% ,84.62%, respectively. The sensitivity, specificity and accuracy of dual-time-point FDG PET/ CT imaging in detecting local and regional recurrence(96.97% ,96.00% and 96.55%)were higher than those of regular FDG PET/CT(90.90%, 72.00% and 82.76%)and there were significant differences of specificity and accuracy(P = 0.049, P = 0.029). Conclusions Regular FDG PET/CT imaging is highly effective in detecting recurrence and metastasis in EC patients after curative esophagectomy despite the low specificity and accuracy. Dual-time-point FDG PET/CT imaging can elevate the specificity and accuracy.  相似文献   

15.
鼻咽癌放射治疗后FDG PET显像的临床价值   总被引:16,自引:0,他引:16  
目的 探讨核医学影像诊断技术--FDG PET在鼻咽癌放射治疗后随诊中的临床价值。方法 12例鼻咽癌患者放射治疗后12~18个月同期行FDG PET和CT、MRI检查,并采用双盲法将PDG PET与CT和MRI结果进行比较,其中6例经活检病理证实,余6例经CT动态观察10个月后确诊。结果 9例CT和MRI未见肿瘤复发,PET显示其中3例有局灶性FDG代谢明显增高病变,2例CT和MRI提示肿瘤复发,FDG PET均显示局部病变有放射性摄取浓聚;该5例FDG摄取浓聚的病变处均经活检病理证实为肿瘤复发。另1例MRI提示鼻咽癌颅内转移,而FDG PET诊断为放射治疗后脑损伤,后经CT随访证实。结论 与CT和MRI检查相比,FDG PET在鼻咽癌放射治疗后肿瘤复发的早期定性诊断上具有明显的优势,若结合CT和MRI多种影像结果分析,更能提供局部病变结构与代谢改变的复合信息,尤其对局部复发病灶精确的适形放射治疗非常重要。  相似文献   

16.

BACKGROUND:

Breast cancer recurrence is often suspected on tumor marker rising in asymptomatic patients. The value of fluorine‐18 fluorodeoxyglucose (18FDG)–positron emission tomography/computed tomography (PET/CT) imaging to detect recurrence and its subsequent impact on patient management were retrospectively assessed.

METHODS:

PET/CT scans were performed on 228 asymptomatic patients (mean, 60.8 years; range, 30‐91 years) presenting with rising CA 15‐3 and/or CEA serum levels.

RESULTS:

PET/CT scans were positive in 181 patients (79.5%) and normal in 47 patients, whereas 187 true recurrences were diagnosed. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PET/CT imaging for detection of breast cancer recurrence were 93.6%, 85.4%, 96.7%, 74.5%, and 92.1%, respectively. When compared with the standard workup available in 67 patients, PET/CT imaging had a higher sensitivity and accuracy (94.5% vs 33% and 94% vs 48%, respectively). Recurrences were confirmed by pathology, conventional imaging techniques, or radiological and clinical follow‐up beyond 1 year (mean, 34 months; range, 12‐67 years) in 32, 130, and 25 patients, respectively. The diagnosis of recurrence led to a treatment modification in 123 patients (54%).

CONCLUSIONS:

18FDG‐PET/CT imaging is an efficient technique to detect breast cancer recurrence suspected on tumor marker rising in asymptomatic patients. It may thus contribute to improve patient management, providing an earlier diagnosis with complete whole‐body staging as a “one‐stop shop” procedure. Cancer 2011. © 2010 American Cancer Society.  相似文献   

17.
目的:探讨^18F-脱氧葡萄糖(FDG)正电子发射型体层摄影术(PET)在头颈部癌瘤复发的临床价值。方法:37例头颈部恶性肿瘤,临床疑复发行FDG PET显像(19例全身显像,18例局部显像),其中34例同期行CT或MRI检查,最后诊断依靠病理检查和临床随访。结果:37例患者中FDG PET显像阳性25例,其中3例假阳性;阴性12例,其中假阴性2例。FDG PET显像的敏感性、特异性和准确率分别为91.7%、76.9%和86.5%,CT或MRI检查的分别为68.2%、75.0%和61.8%。在19例FDG PET全身显像中,11例除头颈FDG异常浓聚外,6例还发现有远地转移。结论:评价头颈部癌瘤复发,FDG PET比CT或MRI有更高准确性。  相似文献   

18.
FDG PET判断鼻咽癌放疗后鼻咽病灶残留的临床价值   总被引:18,自引:3,他引:15  
Chen YR  Gu MX  Li WX  Pan Y 《癌症》2002,21(6):651-653
背景与目的:18F-2脱氧葡萄糖(FDG)正电子发射计算机断层显像(PET)在判断恶性肿瘤治疗后病灶残留上的应用是放射肿瘤学目前研究的热点之一,本文旨在探讨FDG PET显像在鼻咽癌放射治疗后鼻咽肿瘤残留中的应用。方法:25例鼻咽癌放疗后,临床疑咽肿瘤残留,均行FDG PET显像,显像时间为放疗后2-6个月,其中23例同期行CT检查,最后诊断依靠病理检查和临床随访。结果:25例患者中FDG PET显像阳性18例,其中4例假阳性,阴性7例,其中2例假阴性,FDG PET显像的准确率为76.0%(19/25),CT检查的准确率为52.2%(12/23),11例CT未见鼻咽肿瘤残留,FDG PET显示其中2例有鼻咽局部FDG异常浓聚;7例CT诊为肿瘤残留,FDG PET均显示局部病变有FDG异常浓聚,5例CT未能确定残留,PET显示3例FDG异常浓聚,12例FDG异常浓聚的病变处经活检病理证实为肿瘤残留。结论:判断鼻咽癌放疗后鼻咽肿瘤残留,FDG PET比CT有更高的准确性。  相似文献   

19.
Volumetric parameters of positron emission tomography–computed tomography using 18F‐fludeoxyglucose (18F‐FDG PET/CT) that comprehensively reflect both metabolic activity and tumor burden are capable of predicting survival in several cancers. The aim of this study was to investigate the predictive performance of metabolic tumor burden measured by 18F‐FDG PET/CT in ovarian cancer patients who received platinum‐based adjuvant chemotherapy after cytoreductive surgery. Included in this study were 37 epithelial ovarian cancer patients. Metabolic tumor burden in terms of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), clinical stage, histological type, residual tumor after primary cytoreductive surgery, baseline serum carbohydrate antigen 125 (CA125) level, and the maximum standardized uptake value (SUVmax) were determined, and compared for their performance in predicting progression‐free survival (PFS). Metabolic tumor volume correlated with CA125 (r = 0.547, P < 0.001), and TLG correlated with SUVmax and CA125 (SUVmax, r = 0.437, P = 0.007; CA125, r = 0.593, P < 0.001). Kaplan–Meier analysis showed a significant difference in PFS between the groups categorized by TLG (P = 0.043; log–rank test). Univariate analysis indicated that TLG was a statistically significant risk factor for poor PFS. Multivariate analysis adjusted according to the clinicopathological features was carried out for MTV, TLG, SUVmax, tumor size, and CA125. Only TLG showed a significant difference (P = 0.038), and a 3.915‐fold increase in the hazard ratio of PFS. Both MTV and TLG (especially TLG) could serve as potential surrogate biomarkers for recurrence in patients who undergo primary cytoreductive surgery followed by platinum‐based chemotherapy, and could identify patients at high risk of recurrence who need more aggressive treatment.  相似文献   

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