PET-CT在妇科恶性肿瘤诊治中的应用

目的 探讨PET-CT在妇科恶性肿瘤的诊断和治疗中的临床应用。方法 回顾性分析2011年11月~2016年3月在温州医科大学附属第一医院行PET-CT检查的妇科恶性肿瘤患者68例，其中50例血肿瘤标志物正常，CT和（或） MRI诊断为妇科恶性肿瘤；18例CT和（或） MRI检查正常但血肿瘤标志物持续升高。结果 68例患者中宫颈癌21例，卵巢癌40例，子宫内膜癌6例，输卵管癌1例。50例CT和（或） MRI怀疑妇科恶性肿瘤的患者中，17例（34%）患者PET-CT为阴性，改变了治疗方法，避免了不必要的干预。18例CT和（或） MRI阴性但血肿瘤标志物持续升高的患者中，12例（67%）患者PET-CT阳性，比传统的影像学检查更及时、准确的诊断肿瘤的复发，从而指导治疗，改善预后。结论 PET-CT作为一种有效且无创的影像学诊断方法，对于临床制定和调整妇科恶性肿瘤治疗方案有着重要的意义。

Clinical Value of PET-CT in Diagnosis and Treatment of Gynecologic Malignant Tumors

Objective The aim of this study was to evaluate the role of positron emission tomography-CT (PET-CT) in diagnosis and treatment of gynecologic malignancy. Methods This is a retrospective study of 68 patients of gynecologic malignancy registered in The First Affiliated Hospital of Wenzhou Medical University from November 2011 to March 2016. Fifty cases were suspicious or inconclusive lesions on CT and/or MRI with normal serum tumor markers. Eighteen cases were persistently raised serum tumor markers with negative CT and/or MRI findings. Results Out of 68 cases who was detected by PET-CT, the results were as follows:21 cases with cervical cancer, 40 cases with ovarian cancer, 6 cases with endometrial cancer, and 1 cases with cancer of fallopian tube. PET-CT scan was negative in 17 cases (34%) of these patients whose CT and/or MRI scan was suspicious, which changed the therapeutic modality and prevented further unnecessary interventions. In 18 cases whose CT and/or MRI scan was negative but clinical suspicion of recurrence based on rising tumor marker, subsequent PET-CT was diagnosed malignancy in 12 cases (67%). Compared with traditional imaging examination, PET-CT was more timely and accurate in diagnosis of tumor recurrence, which could guide the subsequent treatment and improve prognosis. Conclusion PET-CT, as an effective and noninvasive imaging method, has important clinical significance to formulate and adjust the treatment plan to gynecologic malignancy.