【摘要】 目的:探讨正电子发射断层-计算机(辅助)体层成像(PET-CT)在卵巢恶性肿瘤术后化疗疗效评价、复发监测和预后判断中的价值。方法:对2004年2月至2007年4月北京大学人民医院治疗的58例卵巢恶性肿瘤患者进行18F-氟代脱氧葡萄糖(18F-FDG)PET-CT分析,并将PET-CT结果与同期B超、CT、肿瘤标志物及病理检查结果进行对照研究。结果:58例患者共进行75例次PET-CT检查,发现复发病灶位于阴道断端、膀胱壁层表面、直肠表面、大网膜残端、升结肠旁等常见转移部位及肝、脾被膜周围、纵隔内淋巴结、膈肌下、腹主动脉旁淋巴结等隐匿部位。PET-CT用于监测卵巢恶性肿瘤的灵敏度为100%,特异度为82.8%,阳性预测值为75%,阴性预测值为100%,准确性为88.6%。20例PET-CT阳性患者同时进行二次肿瘤细胞减灭术或二次手术,结果与病理诊断符合率60%;68例次PET-CT检查与B超检查同期进行,符合率77.94%;19例次与CT同期检查,符合率为78.95%;75例次同时进行肿瘤标志物检查,符合率为74.67%;50例次PET-CT检查在患者随访期间进行,与B超、CT和肿瘤标志物检查的符合率为74%。结论:PET-CT作为无创性检查方法,较CT和B超检查能早期诊断卵巢恶性肿瘤的复发,故可进行病情监测,指导临床治疗。更多还原

【Abstract】 Objective:To explore the value of positron emission tomography/computed tomography (PET-CT) in chemotherapy effect evaluation,recurrent monitoring and prognosis of ovarian cancer. Methods:Fifty-eight ovarian cancer patients hospitalized at Peking university people’s hospital from Feb,2004 to Apr,2007 were studied retrospectively,with the whole-body imaging by 18F-fluorodexyglucose (18F-FDG)PET-CT,and the results of PET-CT were compared with those detected by B-ultrasonography,CT,tumor marker (CA125)and pathological results.Results:75 times PET-CT examinations were performed in 58 patients. The common recurrent sites included the end of vagina,sufaces of bladder wall,rectum,residue of greater omentum,ascending colon.Hiding regions included the surround of liver and spleen capsule,the lymph nodes of mediastinum,the under of diaphragm muscle,the paraaortic lymph node,et al. The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET-CT was 100%,82.8%,75%,100% and 88.6% respectively. 20 cases whose PET-CT were positive underwent cytoreduction or second surgery. The coincidence rate with pathological results was 60%. 68 times PET-CT and B-ultrasound were performed simultaneously and the coincidence rate was 77.94%; 19 times PET-CT were coincidence with CT results (78.94%) and 75 times PET-CT were coincidence with tumor markers (74.67%). 50 times PET-CT were performed during follow-up period. The coincidence rate was 74% compared with B-ultrasound,CT and tumor markers. Conclusions:PET-CT as a non-invasive method has advantage over B-ultrasound and CT in early detection of recurrent ovarian cancer,which may be a fairly effective tool in monitoring and follow up.更多还原