Value of Preoperative PET-CT in the Prediction of Pathological Stage of Gastric Cancer
Value of Preoperative PET-CT in the Prediction of Pathological Stage of Gastric Cancer
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DOI：
10.1245/s10434-018-6455-0
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发表时间：
2018-06-01
影响因子：
3.7
通讯作者：
Otsuji, Eigo
中科院分区：
文献类型：
--
作者：
Kudou, Michihiro;Kosuga, Toshiyuki;Otsuji, Eigo
术前精确分期对于胃癌（GC）的治疗至关重要；然而，传统方法的诊断准确性有待提高。本研究探讨了正电子发射断层扫描-计算机断层扫描 (PET-CT) 对 GC 分期的临床价值。这是一项回顾性研究，纳入了 117 名临床诊断为晚期 GC 的患者，这些患者接受了 PET-CT 并随后进行了胃切除术。检查原发肿瘤或淋巴结中FDG摄取的发生率及其与临床病理因素，特别是病理分期（pStage）III/IV的关系。83例患者（70.9%）发现原发肿瘤中FDG摄取。 21例（17.9%）患者检测到淋巴结中FDG摄取，其对淋巴结转移的敏感性和特异性分别为22.7%和90.5%。多元逻辑回归分析显示，原发肿瘤中的 FDG 摄取（比值比 (OR) 2.764；95% 置信区间 (CI) 1.104-7.459，p = 0.029）和淋巴结中的 FDG 摄取（OR 4.660；95% CI 1.675-13.84，p = 0.003）是与 pStage III/IV 独立相关的因素。原发肿瘤中 FDG 的摄取检测到 pStage III/IV 的敏感性更高（80.4%），而淋巴结中的 FDG 摄取发现 pStage III/IV 的特异性（88.7%）高于上消化道内窥镜检查加 CT（分别为 60.9 和 67.6%）。PET-CT 似乎是评估 pStage III/IV 的有用补充方式，因为其高特异性 原发肿瘤中 FDG 摄取的敏感性和淋巴结中 FDG 摄取的高特异性。
Preoperative precise staging is essential for the treatment of gastric cancer (GC); however, the diagnostic accuracy of conventional modalities needs to be increased. The present study investigated the clinical value of positron emission tomography-computed tomography (PET-CT) for the staging of GC.This was a retrospective study of 117 patients with a clinical diagnosis of advanced GC who underwent PET-CT followed by gastrectomy. The incidence of FDG uptake in the primary tumor or lymph nodes and its relationship with clinicopathological factors, particularly pathological stage (pStage) III/IV, were examined.FDG uptake in the primary tumor was noted in 83 patients (70.9%). FDG uptake in the lymph nodes was detected in 21 patients (17.9%), and its sensitivity and specificity for lymph node metastasis were 22.7 and 90.5%, respectively. Multiple logistic regression analyses showed that FDG uptake in the primary tumor (odds ratio (OR) 2.764; 95% confidence interval (CI) 1.104-7.459, p = 0.029) and that in the lymph nodes (OR 4.660; 95% CI 1.675-13.84, p = 0.003) were factors independently associated with pStage III/IV. FDG uptake in the primary tumor detected pStage III/IV with higher sensitivity (80.4%) and that in lymph nodes found pStage III/IV with higher specificity (88.7%) than those of upper endoscopy plus CT (60.9 and 67.6%, respectively).PET-CT appears to be a useful complementary modality in the assessment of pStage III/IV because of the high sensitivity of FDG uptake in the primary tumor and the high specificity of FDG uptake in the lymph nodes.