Diagnostic and prognostic value of 18F-FDG PET/CT for patients with suspected recurrence from squamous cell carcinoma of the esophagus
Diagnostic and prognostic value of 18F-FDG PET/CT for patients with suspected recurrence from squamous cell carcinoma of the esophagus
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DOI：
10.2967/jnumed.106.036509
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发表时间：
2007-08-01
影响因子：
9.3
通讯作者：
Yu, Jinming
中科院分区：
文献类型：
--
作者：
Guo, Hongbo;Zhu, Hui;Yu, Jinming
食管鳞状细胞癌（ESCC）患者通常在初次治疗后2年内复发的风险很高。本研究的目的是评估F-18-FDG PET/CT在接受明确治疗的可能复发ESCC患者中的作用。方法：对五十六例食管鳞癌患者进行PET/CT扫描。PET/CT结果通过组织病理学或至少6个月的临床随访进行验证。计算PET/CT检测复发的敏感性、特异性和准确性。根据末次随访时的状态（复发或无复发、存活或死亡）对患者进行分组，比较标准化摄取值（SUV）。采用Kaplan-Meier法估计总生存率。采用考克斯比例风险模型评估单变量和多变量生存分析的独立预后变量。结果：45例（80.4%）患者72个（66.1%）恶性部位复发. PET/CT检查有9例假阳性，5例假阴性。PET/CT检测所有部位复发的总体敏感性、特异性和准确性分别为93.1%（67/72）、75.7%（28/37）和87.2%（95/109）。PET/CT在局部和远处部位具有高度敏感性、特异性和准确性。在当地站点，敏感性高，但特异性较低（50%），因为假阳性结果的发生率高。在末次随访时确认复发或死亡的患者的SUV较高（P = 0.027，
Patients with esophageal squamous cell carcinoma (ESCC) are commonly at high risk of recurrence within 2 y after initial treatment. The aim of this study was to evaluate the role of F-18-FDG PET/CT in patients with possibly recurrent ESCC who underwent definitive treatment. Methods: Fifty-six patients with previously treated ESCC underwent PET/CT scans. The PET/CT findings were validated by histopathology or clinical follow-up of at least 6 mo. The sensitivity, specificity, and accuracy of PET/CT for detecting recurrence were calculated. Comparison of the standardized uptake value (SUV) was performed between patients grouped according to their status at the last follow-up (relapsed or relapse-free, alive or dead). The overall survival rates were estimated by the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate independent prognostic variables for both univariate and multivariate survival analysis. Results: Forty-five (80.4%) patients had recurrence in 72 (66.1 %) malignant sites. On PET/CT, there were 9 false-positive and 5 false-negative results. The overall sensitivity, specificity, and accuracy of PET/CT for detecting recurrence at all sites were 93.1% (67/72), 75.7% (28/37), and 87.2% (95/109), respectively. PET/CT was highly sensitive, specific, and accurate at regional and distant sites. At local sites, sensitivity was high, but specificity was lower (50%) because of a high incidence of false-positive findings. Patients who were confirmed with recurrence or who had died at the last follow-up had higher SUVs (P = 0.027 and