Improving Patient Selection for 18F-FDG PET Scanning in the Staging of Gastric Cancer
Improving Patient Selection for 18F-FDG PET Scanning in the Staging of Gastric Cancer
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DOI：
10.2967/jnumed.114.150946
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发表时间：
2015-04-01
影响因子：
9.3
通讯作者：
Duong, Cuong
中科院分区：
文献类型：
--
作者：
Kaneko, Yui;Murray, William K.;Duong, Cuong
胃癌的标准治疗前分期包括胸部、腹部和骨盆 CT；胃镜;和腹腔镜检查。尽管 F-18-PET 结合 CT 已被证明是许多癌症的有用分期工具，但某些胃癌并不热衷于 F-18-FDG，其临床价值仍存在争议。方法：对 2002 年至 2013 年在 Peter MacCallum 癌症中心接受分期 F-18-FDG PET 扫描的胃癌患者进行回顾性分析，并使用 PubMed 于 2000 年至 2014 年 3 月进行系统评价，以调查与 F-18-FDG 亲和力相关的临床病理参数。治疗前 PET 评分系统是根据 F-18-FDG 亲合力的预测因子开发的。结果：对患者的回顾性分析和系统文献回顾均显示 F-18-FDG 亲合力具有相似的显着预测因素，包括肿瘤大小、非印戒细胞癌类型和免疫组织化学上葡萄糖转运蛋白 1 阳性表达。根据这些临床病理参数开发了 PET 评分系统，该系统能够以 85% 的灵敏度和 71% 的特异性检测 F-18-FDG 亲和的肿瘤。结论：在考虑进行 F-18-FDG PET 分期时，治疗前 PET 评分系统可以帮助选择胃腺癌患者。
Standard pretreatment staging for gastric cancer includes CT of the chest, abdomen, and pelvis; gastroscopy; and laparoscopy. Although F-18-PET combined with CT has proven to be a useful staging tool in many cancers, some gastric cancers are not F-18-FDG-avid and its clinical value is still debatable. Methods: Gastric cancer patients who underwent staging F-18-FDG PET scans from 2002 to 2013 at the Peter MacCallum Cancer Center were retrospectively analyzed, and a systematic review was also conducted using PubMed between 2000 to March 2014 to investigate clinicopathologic parameters associated with F-18-FDG avidity. A pretreatment PET scoring system was developed from predictors of F-18-FDG avidity. Results: Both the retrospective analysis of the patients and the systematic literature review showed similar significant predictors of F-18-FDG avidity, including large tumor size, non signet ring cell carcinoma type, and glucose transporter 1 positive expression on immunohistochemistry. A PET scoring system was developed from these clinicopathologic parameters that allowed F-18-FDG-avid tumors to be detected with a sensitivity of 85% and a specificity of 71%. Conclusion: A pretreatment PET scoring system can assist in the selection of patients with gastric adenocarcinoma when staging F-18-FDG PET is being considered.