| 18F-FDG PET/CT显像在鼻咽癌综合治疗后随访中的诊断及预后评估效能 |
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| 引用本文： | 田月丽,兰晓莉,吴志坚,贾清,何勇,张永学. 18F-FDG PET/CT显像在鼻咽癌综合治疗后随访中的诊断及预后评估效能[J]. 中国医学影像技术, 2013, 29(3): 349-353 |
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| 作者姓名： | 田月丽 兰晓莉 吴志坚 贾清 何勇 张永学 |
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| 作者单位： | 华中科技大学同济医学院附属协和医院核医学科 湖北省分子影像重点实验室,湖北武汉,430022 |
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| 基金项目： | 国家高技术研究发展计划(863计划)项目(2008AA02Z426)。 |
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| 摘 要： | 目的 评价18F-FDG PET/CT显像对鼻咽癌患者综合治疗后随访的诊断效能及其预后评估价值.方法 收集鼻咽癌综合治疗后患者89例,回顾18F-FDG PET/CT和常规影像学诊断结果,并与组织病理学诊断和(或)长期临床随访资料进行比较,计算18F-FDG PET/CT与常规影像学在鼻咽癌综合治疗后对残留、复发或转移诊断的灵敏度、特异度、准确性、阳性预测值(PPV)及阴性预测值(NPV).结合18F-FDG PET/CT图像及患者临床表现做定性诊断,勾画鼻咽部局部病灶并测量最大标准摄取值(SUVmax).以ROC曲线确定18F-FDG PET/CT诊断最佳SUVmax,以定性诊断结果和ROC曲线最佳SUVmax为界点行生存分析,以性别、年龄、鼻咽部SUVmax、治疗方法、病灶数目进行COX比例风险回归模型分析,观察影响整体生存率(OS)及无病生存率(DFS)的因素.结果 89例患者平均生存(69.22±4.46)个月,5年OS为73.00％.18F-FDG PET/CT诊断灵敏度、特异度、准确率、PPV及NPV分别为100％(59/59)、90.20％ (46/51)、95.45％(105/110)、92.19％(59/64)和100％ (46/46)；传统影像学分别为75.86％ (44/58)、78.85％ (41/52)、77.27％ (85/110)、80.00％(44/55)和72.73％(40/55),18F-FDG PET/CT灵敏度和准确率高于传统影像学(P均＜0.01).鼻咽部SUVmax=2.5时18F-FDG PET/CT诊断效能最佳,SUVmax＜2.5患者5年OS为81.90％,高于SUVmax≥2.5者为62.00％ (P=0.036).18F-FDG PET/CT阴性患者5年OS为100％,阳性者59.90％ (P=0.006).COX比例风险回归模型分析显示,根据SUVmax[相对危险度(RR) =1.205；P=0.014]和病灶数目(RR=2.734;P=0.005)可预测OS,病灶数目是影响DFS(RR=2.105；P=0.008)的主要因素.结论 18F-FDG PET/CT诊断鼻咽癌患者综合治疗后复发和(或)转移具有较高灵敏度和准确率；鼻咽部SUVmax=2.5可能是18F-FDG PET/CT诊断的最佳界值点；18F-FDG PET/CT定性诊断为阳性以及鼻咽部SUVmax≥2.5患者的远期生存预后不佳.根据鼻咽部SUVmax和病灶数目可以预测OS,病灶数目同时是影响DFS的主要因素.
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| 关 键 词： | 鼻咽肿瘤 正电子发射型体层摄影术 体层摄影术,X线计算机 18F氟脱氧葡萄糖 预后 |
| 收稿时间： | 2012-03-22 |
| 修稿时间： | 2012-05-03 |
Efficacy of 18F-FDG PET/CT in diagnosis and prognosis for nasopharyngeal carcinoma patients during follow-up after comprehensive therapy |
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| TIAN Yue-li,LAN Xiao-li,WU Zhi-jian,JIA Qing,HE Yong and ZHANG Yong-xue. Efficacy of 18F-FDG PET/CT in diagnosis and prognosis for nasopharyngeal carcinoma patients during follow-up after comprehensive therapy[J]. Chinese Journal of Medical Imaging Technology, 2013, 29(3): 349-353 |
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| Authors: | TIAN Yue-li LAN Xiao-li WU Zhi-jian JIA Qing HE Yong ZHANG Yong-xue |
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| Affiliation: | Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China;Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China;Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China;Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China;Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China;Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China |
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| Abstract: | |
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| Keywords: | Nasopharyngeal neoplasms Positron-emission tomography Tomography, X-ray computed Fluorodeoxyglucose F18 Prognosis |
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