无症状体检人群中~(18)F-FDG PET/CT筛查恶性肿瘤的应用价值

目的评估无症状体检人群中18F-FDG PET/CT筛查恶性肿瘤的应用价值。方法选取2011年1月~2014年12月在解放军总医院健康管理研究院应用18F-FDG PET/CT筛查恶性肿瘤的无症状体检人群4 899例,平均年龄(51.8±9.5)岁,男性3 390例(69.2%),女性1 509例(30.8%)。结果 PET/CT检查发现可疑高代谢或占位病灶,经穿刺或手术病理证实的恶性肿瘤72例,包括肺癌、甲状腺癌以及结肠癌等13种肿瘤,筛查阳性率为1.5%。PET/CT筛查假阴性8例,假阳性65例,筛查的敏感度为90.0%,特异性为99.8%,阳性预测值52.6%,阴性预测值98.4%。结论体检人群中PET/CT筛查可发现全身多部位的早期恶性肿瘤。为减少假阴性和假阳性,PET/CT筛查恶性肿瘤应与甲状腺、肝脏超声及胃肠镜检查相结合。低阳性预测值及射线暴露诱发肿瘤的风险是在无症状体检人群中应用PET/CT筛查恶性肿瘤时应重视的问题,应注意选择适应症,防止滥用检查和过度医疗。

The application of 18F-FDG PET/CT imaging for cancer screening in asymptomatic individuals

Objective To evaluate the potential application of 18-fluorodeoxyglucose positron emission tomography computed tomography (18F FDG PET-CT) for cancer screening in asymptomatic individuals. Methods We conducted a prospective analysis of asymptomatic individuals using 18F-FDG PET/CT to screen for cancer in the Health Management Institute of PLA General Hospital from January 2011 to December 2014. A total of 4899 subjects were enrolled, with a mean age of 51.8 ± 9.5 years, including 3390 males (69.2%) and 1509 females (30.8%). Results Malignant tumours were discovered in 72 cases among 13 organs, including the lung, thyroid and colon. The cancer detection rate was 1.5%. PET/CT false-negative results were identified in 8 cases, and PET/CT false-positive results were identified in 65 cases. PET/CT screening had a sensitivity of 90.0% and a specificity of 99.8%. The positive predictive value and the negative predictive value were 52.6% and 98.4%, respectively. Conclusion 18F FDG PET/CT has the potential to detect a wide variety of cancers at curable stages in asymptomatic individuals receiving check-ups. To reduce false-positive and false-negative results, ultrasound (thyroid gland and the liver) and endoscopy are also needed for cancer screening in addition to FDG PET/CT.