摘要
目的：探讨18F-FDG PET/CT在肝细胞癌治疗后AFP升高而常规检查不能明确诊断的患者中的临床应用价值。方法：回顾性分析肝细胞癌行外科切除、肝动脉化疗栓塞（TACE）或射频消融（RFA）术治疗后AFP升高而常规检查未发现异常的17例患者的18F-FDG PET/CT图像，并和组织学、影像学及临床随访对比，临床随访时间均大于6个月。结果：17例患者中12例确诊肝细胞癌复发，6例病灶位于肝内，3例病灶位于肝外，3例肝内外均发现病灶。肝外病灶为淋巴结转移3例，骨转移1例，双肺及左腹直肌转移1例，双肺及右膈肌脚转移1例。18F-FDG PET/CT诊断肝内复发7例，肝外转移6例。18F-FDG PET/CT诊断肝细胞癌治疗后复发真阳性10例，假阴性3例，真阴性4例，假阳性0例，其灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为77%、100%、82%、100%、57%。结论：对肝细胞癌治疗后AFP升高而常规检查正常患者，18F-FDG PET/CT对发现其肝内复发及肝外转移有重要临床价值。
Abstract
Objective: The aim of this study was to evaluate the value of 18F-FDG PET/CT in investigating hepatocellular carcinoma(HCC) with unexplained serum AFP elevation following surgical resection, transarterial chemoembolization(TACE) or radiofrequency ablation(RFA). Methods: A retrospective study was conducted involving 17 HCC patients who underwent 18F-FDG PET/CT to explain the evaluation of AFP without evidence of HCC recurrence examined by routine imaging. The 18F-FDG PET/CT results were correlated with histological findings, as well as long-term radiological and clinical follow-up(shortest follow-up period after FDG-PET was 6 months). Results: Among 17 patients, 12 patients demonstrated HCC recurrence(6 intrahepatic, 3 extrahepatic and 3 intrahepatic/extrahepatic). Metastatic foci were found in lymph node(3 patients), bone(1 patient), lung and muscle(1 patient), lung and crura of diaphragm (1 patient). The 18F-FDG PET/CT identified 7 intrahepatic and 6 extrahepatic. Overall, 18F-FDG PET/CT had 10 true-positives, 3 false-negatives, 4 true-negatives and no false-positives for the detection of HCC recurrence. The sensitivity, specificity, positive predictive value and negative predictive value were 77%, 100%, 82%, 100%, 57%, respectively. Conclusions: When conventional examinations are normal, the 18F-FDG PET/CT examination is a valuable imaging tool in patients who have elevated AFP value after HCC treatment.
关键词
癌 /
肝细胞 /
甲胎蛋白类 /
正电子发射断层显像术 /
体层摄影术 /
螺旋计算机
Key words
Carcinoma /
hepatocellular /
Alpha-fetoproteins /
Positron-emission tomography
周 硕;林美福;陈文新;何品玉;陈彩龙;陈国宝;李君霞.
18F-FDG PET/CT在肝细胞癌治疗后不明原因AFP升高者中的临床应用价值[J]. 中国临床医学影像杂志. 2010, 21(9): 629-631
ZHOU Shuo;LIN Mei-fu;CHEN Wen-xin;HE Pin-yu;CHEN Cai-long;CHEN Guo-bao;LI Jun-xia.
The clinical value of 18F-FDG PET/CT for investigating elevation of serum AFP inpatients with hepatocellular carcinoma after treatment[J]. Journal of China Clinic Medical Imaging. 2010, 21(9): 629-631
中图分类号：
Ｒ735.7
Ｒ817.4
R814.42
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