Preoperative evaluation of patients with primary head and neck cancer using dual-head 18fluorodeoxyglucose positron emission tomography
Preoperative evaluation of patients with primary head and neck cancer using dual-head 18fluorodeoxyglucose positron emission tomography
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DOI：
10.1097/00000658-200002000-00012
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发表时间：
2000-02-01
影响因子：
9
通讯作者：
van Rijk, PP
中科院分区：
文献类型：
--
作者：
Stokkel, MPM;ten Broek, FW;van Rijk, PP
目的：评估（18）氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在原发性头颈部癌症中的价值。
背景资料：头颈部癌倾向于转移至区域淋巴结，而非血行播散。出现淋巴结转移时，治愈率大约降低50%。此外，大约3%的患者在初诊时发现第二原发肿瘤。
方法：对54例连续的未经治疗的口腔或口咽鳞状细胞癌患者（31例男性和23例女性；平均年龄60岁，范围34 - 81岁）进行了研究。在手术前3周内，进行了临床检查、胸部X线、计算机断层扫描（CT）、超声引导下细针穿刺细胞学检查（US/FNAC）以及FDG - PET检查。所有研究结果按颈部两侧分别评分，并且也分为0（无转移）、1（单个转移）或2（多个转移）。
结果：对于颈部每一侧淋巴结转移的检测，FDG - PET、CT和US/FNAC的敏感性分别为96%、85%和64%。特异性分别为90%、86%和100%。就分类而言，FDG - PET与组织学数据的相关性最好。最后，在9例患者（17%）中，FDG - PET检测到第二原发肿瘤，并经组织学评估证实。
结论：由于FDG - PET检测到第二原发肿瘤的高发生率，以及与CT和US相比在评估淋巴结受累方面错误率降低，原发性头颈部癌症患者应常规进行FDG - PET检查。
ObjectiveTo evaluate the value of (18)fluorodeoxyglucose (FDG) positron emission tomography (PET) in primary head acid neck cancer.Background DataHead and neck carcinomas tend to metastasize to regional lymph nodes rather than to spread hematogenously. With nodal metastases, cure rates decrease by approximately 50%. Moreover, in approximately 3% of the patients, a second primary tumor is found at initial presentation.MethodsFifty-four consecutive patients (31 men and 23 women; mean age 60 years, range 34-81 years) with previously untreated squamous cell carcinomas of the oral cavity or oropharynx were studied. Before surgery and within a period of 3 weeks, clinical examination, chest x-ray, computed tomography (CT), ultrasonography with fine-needle aspiration cytology (US/ FNAC), and FDG-PET were performed. All study results were scored per neck side and were also classified as 0 (no metastases), 1 (single metastasis), or 2 (multiple metastases).ResultsThe sensitivity for the detection of lymph node metastases per neck side was 96%, 85%, and 64% for FDG-PET, CT, and US/FNAC, respectively. The specificity was 90%, 86%, and 100% for FDG-PET, CT, and US/FNAC, respectively. In terms of the classification, FDG-PET showed the best correlation with the histologic data. Finally, in nine patients (17%), a second primary tumor was detected by FDG-PET and confirmed by histologic evaluation,ConclusionBecause of the high prevalence of second primary tumors detected by FDG-PET and the decreased error rate in the assessment of lymph node involvement compared with CT and US, FDG-PET should be routinely performed in patients with primary head and neck cancer.