PET/CT显像在妇科恶性肿瘤术后复发及转移中的临床应用价值

目的:探讨正电子发射断层显像(PET/CT)在诊断妇科恶性肿瘤术后复发与转移中的临床应用价值。方法:回顾性分析2015年1月至2016年12月，在我中心行PET/CT检查的56例妇科恶性肿瘤术后患者的全身PET/CT的显像结果，确诊依据为术后病理结果、血糖类抗原125（CA125）持续升高水平和临床随诊结果，评价PET/CT对妇科恶性肿瘤术后复发、转移的诊断效能。结果:56例患者中，经病理结果、血CA125持续升高水平、临床随诊结果证实，肿瘤复发及转移者25例，没有复发、转移者26例，假阳性者3例，假阴性者2例，PET/CT显像在妇科恶性肿瘤术后复发及转移的灵敏度、特异性、准确率分别为92.6%（25/27）、89.7%（26/29）、91.1%（51/56）；转移灶分为阴道残端、全身淋巴结、远处器官转移，PET/CT显像对各转移灶的灵敏度及特异性分别为87.5%(7/8)和97.9%(47/48)、95.0%（19/20）和91.7%（33/36）、91.3%（21/23）和90.9%（30/33）；PET/CT显像发现全身多部位、多器官转移的6人，改变了临床分期及治疗方案。结论:PET/CT显像对妇科恶性肿瘤术后复发及转移的诊断，具有较高的灵敏度和特异性，对肿瘤术后复发及转移的临床分期及治疗方案的确定具有非常大的指导意义。

Clinical value of PET/CT imaging in the recurrence and metastasis of gynecologic malignant tumors postoperatively

Objective:To investigate the clinical value of positron emission tomography (PET/CT) in the recurrence and metastasis of gynecologic malignant tumors.Methods:We analyzed retrospectively the imaging results of 56 patients with postoperative gynecological malignant tumors who underwent PET/CT in our center from January 2015 to December 2016.The diagnosis was evaluated by postoperative pathological results,the elevated level of blood glucose anti-tumor antigen 125 (CA125) and the clinical follow-up results.The diagnostic efficacy of PET/CT on the recurrence and metastasis of gynecological malignant tumor was evaluated.Results:In 56 patients,the pathological results,the continuous elevation of serum CA125 level and clinical follow-up results confirmed that 25 cases of tumor recurrence and metastasis,26 cases of metastasis without recurrence,3 cases of false positive,2 false negative cases.The specificity,sensitivity and accuracy of PET/CT imaging in gynecological malignant tumor recurrence and metastasis were 92.6%(25/27),89.7%(26/29),91.1%(51/56),respectively.Lesions were divided into vaginal stump,systemic lymph node and distant metastasis,the sensitivity and specificity of the PET/CT imaging of each metastasis were 87.5%(7/8) and 97.9%(47/48),95.0%(19/20) and 91.7%(33/36),91.3%(21/23) and 90.9%(30/33).PET/CT imaging showed that 6 patients have multiple sites and organ metastasis of the whole body,changed the clinical staging and treatment plan.Conclusion:PET/CT imaging has high sensitivity and specificity for metastasis and recurrence of gynecologic malignancies postoperatively.It has great guideline for the clinical stage and the treatment plan of postoperative recurrence and metastasis of gynecologic malignancies.