增强CT和PET/CT对胰腺癌诊断及分期中的价值

目的 探讨增强CT和PET/CT对胰腺癌诊断及分期中的价值.方法 回顾性分析安徽医科大学第一附属医院普外科2009年10月至2013年10月间收治47例手术治疗的胰腺占位患者资料.术前均行CA19-9检查、腹部增强CT扫描及全身PET/CT扫描,比较增强CT与PET/CT在胰腺癌诊断及分期中价值.结果 47例患者中,确诊胰腺癌41例,非胰腺癌6例.CA19-9、增强CT和PET/CT对胰腺癌诊断的灵敏度分别为78.0％、80.4％和95.1％,PET/CT灵敏度优于CA19-9和增强CT,差异有统计学意义（P值分别为0.023和0.043）;在胰周淋巴结转移判断方面,PET/CT和增强CT的灵敏度分别为75.0％和41.6％,二者差异有统计学意义（P=0.019）;在肝转移判断方面,PET/CT和增强CT诊断的灵敏度分别为80.0％和60.0％,二者差异无统计学意义（P=1.0）.结论 PET/CT对胰腺癌诊断有较高灵敏度,显著优于增强CT.当肿瘤SUV值升高,PET/CT诊断仍应注意结合CA19-9、增强CT甚至MRI综合判断;PET/CT有助于发现淋巴结和远处器官转移病灶,获得更加准确的术前分期,从而避免诊断性剖腹探查手术.

The value of 18F-FDG PET/CT in primary diagnosis and staging of pancreatic cancer

Objective To investigate the value of enhanced CT and 1s F-FDG PET/CT in assessing the diagnose and staging of pancreatic cancer.Methods 47 consecutive patients with suspicion of pancreatic tumor were enrolled.Patients underwent a protocol including 18F-FDG-PET/CT,enhanced CT and CA19-9.The findings were confirmed by histopathologic at operation analysis.Results of TNM classification of different imaging methods were compared with clinical TNM classification.Results Pancreatic adenocarcinoma was diagnosed in 41 patients,and other 6 patients were benign diseases.The diagnostic sensitivity of FDG-PET/CT for pancreatic malignancy was 95.1%,compared with 78.0% and 80.4% for CA19-9 and enhanced CT,respectively.PET/CT had a sensitivity of 75.0% for N-and 80.0% for M-staging.The enhanced CT had sensitivities of 41.6% for N-and 60.0% for M-staging.Conclusion 18F-FDG-PET/CT was more sensitive than enhanced CT in the diagnosis of both primary pancreatic adenocarcinoma and associated distant metastases.In contrast,the sensitivity of FDG-PET/CT was poor in detecting local lymph node metastasis,which would have been important for an assessment of resectability.