^18F-FDG PET/CT显像对胃肠道恶性肿瘤分期、术后再分期诊断的临床价值

目的评价18F-FDG PET/CT显像对胃肠道恶性肿瘤分期、术后再分期诊断的临床价值。方法回顾性分析25例原发及52例胃肠道肿瘤术后患者全身PET/CT显像结果。原发灶皆经组织病理学检查确诊（手术或内窥镜活检术取得病理组织）,确诊肿瘤复发、转移的依据为再次手术后病理、胃镜、结直肠镜、多种影像学检查及临床随访,本组随访6-32个月,平均17个月。结果25例原发胃肠道肿瘤患者,PET/CT对肿瘤原发病灶诊断准确率96%（24/25）。PET/CT分期诊断的灵敏度83.3%（10/12）,特异度92.3%（12/13）,阳性预测值90.9%（10/11）,阴性预测值85.7%（12/14）,准确度88%（22/25）。PET/CT再分期诊断的灵敏度97.1%（34/35）,特异度82.4%（14/17）,阳性预测值91.9%（34/37）,阴性预测值93.3%（14/15）,准确度92.3%（48/52）。治疗方案改变28.6%（22/77）。结论PET/CT能准确、灵敏地检测胃肠道肿瘤原发病灶、转移以及复发病灶,对临床治疗决策有重要影响。18F-FDGPET/CT显像对胃肠道恶性肿瘤的分期、术后再分期诊断有较高的临床价值。

Value of ^18F-FDG PET/CT Imaging on Diagnosis, Staging, Restaging for Gastrointestinal Tumor

Objective To investigate the clinical value of fluorine-18-labeled fluorodeoxyglucose（^18F-FDG） positron emission tomograpy/computed tomograpy（PET/CT） imaging on diagnosis, staging, restaging for gastrointestinal tumor. Methods The results of PET/CT over 75 patients with gastrointestinal tumors were retrospectively reviewed. The primary lesions were all proved by pathology. The diagnosis of recurrence tumor and/or metastasis was based on pathologic examination, colonoscopy, multi-modality imaging and clinical follow-up. The average follow-up time was 17 months. Results The primary tomour was visualized in 96%（24/25） with PET/CT. The sensitivity,specificity, positive predictive value（PPV）,negative predictive value（NPV） and accuracy of PET/CT in staging were 83.3%（10/12）,92.3%（12/13）, 90.9%（10/11）,85.7%（12/14）and 88%（22/25）respectively. The sensitivity,specificity,PPV,NPV and accuracy of PET/CT in restaging were 97.1%（34/35）,82.4% （14/17）,91.9%（34/3 7）,93.3%（14/15）and 92.3%（48/52）respectively. The clinical therapeutic strategies were changed in 22 cases due to the results of PET/CT,and the influence rate of PET/ CT was 28.6 %（22/77）.Conclusion PET/CT can detect the primary lesions, recurrence and metastasis of gastrointestinal tumor with high sensitivity and accuracy. F-FDG PET/CT imaging 18 has increased accuracy of the diagnosis, staging, restaging for gastrointestinal tumor.