18F-FDG PET/CT显像对胃癌术前分期的临床价值

目的：探讨18F-脱氧葡萄糖（18F-FDG）PET/CT显像对胃癌TNM分期的临床价值。方法：对33例胃癌初诊患者于手术前2周内行18F-FDG PET/CT检查，将33例手术治疗患者的PET/CT结果与病理学检查、其他影像结果及临床随访结果相比较。结果：将PET/CT显像TNM分期与手术病理学检查TNM分期进行对比分析，结果证明对胃癌原发灶的检出，18F-FDG PET灵敏度为84.8％，PET/CT为100％。18F-FDG PET/CT显像与手术病理学检查比较，对T分期、N分期、M分期的一致性分别为81.8％、75.8％、93.9％，对TNM分期的一致性为90.9％（Kappa值分别为0.514、0.557、0.767、0.759，P<0.01)。结论：18F-FDG PET/CT显像对胃癌的TNM分期具有重要价值，且PET/CT检查结果与手术病理学检查结果有较好的一致性，但应注意印戒细胞癌等细胞类型易出现的假阴性。

Clinical application of 18F-FDG PET/CT in the staging of gastric carcinoma

Objective：To assess the clinical application value of 18F-FDG PET/CT on TNM staging of gastric cancer.Methods：PET/CT scan were performed in 33 newly diagnosed gastric carcinoma patients within two weeks before operation.Primary lesions,lymph nodes metastasis and distant metastasis of all patients were diagnosed by pathological examination,other imaging findings and clinical follow up for more than 6 months.The value of PET/CT in the diagnosis and staging of gastric cancer was assessed by comparing the findings of PET/CT with the clinical findings.Results：Compared with operative pathology in 33 patients,the sensitivity of 18F-FDG PET and PET/CT for diagnosing primary lesions of gastric cancer were 84.8%and 100%.In 33 patients,the diagnostic concordance of PET/CT with pathological and clinical findings for T-stage,N-stage,M-stage and TNM-stage were 81.8%,75.8%,93.9% and 90.9%,respectively（Kappa value was 0.514,0.557,0.767 and 0.759 respectively,P0.01）.Conclusions： 18F-FDG PET/CT plays an important role in the diagnosis and TNM staging for gastric cancer with a good concordance of TNM staging with operative pathology.False-negative commonly occurs in patients with signet-ring cell carcinoma and especial attention should be paid on them.