PET-CT诊断胃癌腹膜转移的临床价值

目的评价正电子发射体层摄影-CT(PET-CT)诊断胃癌腹膜转移的价值。方法2002年11月至2006年1月,141例胃癌患者在日本静冈县立癌症中心接受了PET-CT检查,其中114例同时接受了多层螺旋CT检查,并与细胞学检查、病理活检和临床表现作了比较。结果PET-CT诊断胃癌腹膜转移的准确率为87.9%,灵敏度74.4%,特异度93.1%,阳性预测值80.6%,阴性预测值90.5%,显著优于多层螺旋CT的78.1%、39.4%、93.8%、72.2%和79.2%(P<0.01)。15例Cy1P0病例,PET-CT与多层螺旋CT检测的灵敏度分别为53.3%和13.3%,无统计学差异(P=0.053);19例P1病例,PET-CT与多层螺旋CT检测的灵敏度分别为84.2%和63.2%,也无统计学差异(P=0.141)。结论PET-CT对于诊断胃癌腹膜转移有一定的临床价值。

Clinical value of PET-CT in diagnosing peritoneal metastasis of gastric cancer

Objective To evaluate the clinical value of positron emission tomography-CT(PET-CT)in diagnosing peritoneal metastasis of gastric cancer.Methods A total of 141 cases of gastric cancer accepted PET-CT from November 2002 to January 2006 in Shizuoka Cancer Center Hospital & Research Institute,among whom 114 were also performed multi-slice spiral CT(MSCT)as control.The results were compared with cytological examination,pathological biopsy and clinical manifestation.Results The accuracy of PET-CT for peritoneal metastasis was 87.9%,sensitivity 74.4%,specificity 93.1%,PPV 80.6% and NPV 90.5%,significantly better than those of MSCT(78.1%,39.4%,93.8%,72.2%,and 79.2%,respectively;P<0.01).In 15 cases of Cy1P0,PET-CT showed a seemingly better sensitivity of 53.3% vs 13.3% of MSCT,although not statistically significant(P=0.053).And in P1 cases,PET-CT and MSCT manifested sensitivity of 84.2% and 63.2%,respectively,without statistical significance(P=0.141).Conclusion PET-CT is useful in predicting peritoneal metastasis of gastric cancer.