F18FDGPET对肾细胞癌诊治临床作用初步研究.docVIP

F-18 FDG-PET 对肾细胞癌诊治临床作用初步研究 　　作者：邵志强 郑少斌 谭万龙 陈彤 齐桓 姜耀东 肖耀军 张辉见 　　【摘要】目的评价F-18 FDG-PET 对肾细胞癌诊断和治疗方案选择的临床作用。方法对怀疑或诊断为原发性肾细胞癌的 40 例病人进行全身 PET 检查，确诊依靠病理或随访，比较 PET 与CT 诊断价值并分析 PET 检查结果对治疗方案选择的影响。结果40 例中39 例最后诊断为原发性肾细胞癌，PET 检查结果真阳性 30 例，假阴性 9 例，假阳性 1 例(为局部肾间质纤维化)，而 CT 真阳性 36 例;35 例常规检查后拟行手术治疗，PET 改变治疗方案 5 例(5/35)：1 例行肾部切除术;1 例因发现双肺多发转移，放弃手术;确诊 3 例，直接行肾癌根治手术。结论PET 对原发性肾细胞癌诊断敏感性不如 CT，但对 CT 等常规影像检查不能确诊的肾细胞癌患者有帮助，能改变约14%术前治疗方案。 　　【关键词】肾细胞癌;FDG F-18;PET(正电子发射体层扫描) 　　Clinical role of F-18 fluorodeoxyglucose positron emission tomography for detectionand management of renal cell carcinoma:preliminary experience 　　SHAO ZhiqiangZHENG ShaobinTAN Wanlonget al 　　Department of Urology,Nanfang Hospital,Southern Medical University,Guangzhou510515,China 　　【Abstract】ObjectiveTo evaluate the clinical role of F-18 fluorodeoxyglucose (FDG)-positron emission tomography (PET)for detection and management of renal cell carcinoma.MethodsFDG-PET was performed in 40 patients with suspected or known primary renal tumors and compared with computerized tomography (CT).Histopathological confirmation was obtained in 35 patients and confirmation of the disease was by followup in the remainder.The impact of FDG-PET on disease management was also assessed.ResultsOf the 40 patients with known or suspected primary tumors FDG-PET was true positive in 30,false-negative in 9 and false-positive in 1.Comparative CT was true positive in 36.35 patients would have undergone operation after conventional imaging findings but FDG-PET results altered treatment decisions for 5(14%),of whom 1 underwent partial nephrectomy and 1 avoided surgery due to detection of unsuspected multiple metastases to the lung parenchyma and 3 were confirmed and performed directly radical nephrectomy.ConclusionThe sensitivity of FDG-PET in the detection of RCC is lower than CT,but it may have a complementary role in cases that are equivocal on conventional imaging and altered treatment in 14% preoperatively. 　　【Ke