18F-FDG PET/CT显像在胃癌术后复发和转移中的诊断价值

目的：探讨18F-FDG PET/CT显像在胃癌术后复发及转移灶诊断中的价值。方法：胃癌术后患者112例，共行PET/CT检查150例次，图像分析采用视觉及半定量分析法（SUVave），病灶根据病理学检查结果、多种影像学检查手段及临床随访确诊，随访时间半年以上。结果：112例患者中，16例存在肿瘤复发和转移，PET/CT诊断残胃复发的灵敏度为81.2%，特异性100%，准确性97.3%。复发病灶SUVave为4.4±1.2，吻合口炎性病灶SUVave为2.6±0.5，两者差异显著（t=3.9370，P=0.0005）。PET/CT诊断胃癌术后肿瘤转移的灵敏度94.1%、特异性96.7%和准确性95.5%。26例行两次以上PET/CT检查，第一次PET/CT检查发现复发或转移15例，经放化疗后6例PET显像示病情好转，随访6个月至2年患者均存活；9例治疗后PET显像示病情无明显变化或者出现新病灶，患者存活时间为3个月至1年。结论：18F-FDG PET/CT在胃癌术后复发和转移中有很好的诊断价值，并在监测胃癌术后复发放化疗疗效有一定的价值。

18F-FDG PET/CT imaging in the diagnosis of postoperative of gastric cancer recurrence and metastasis

Objective：To assess the value of 18F-fluorodeoxyglucose positron emission and computed tomography（18F-FDG PET/CT） in the post-operative patients with gastric cancer recurrence and metastasis.Methods：Of all the 112 patients who had received PET/CT examination for 150 times,the image analysis using visual and semi-quantitative analysis（SUVave）,lesions confirmed according to the results of pathological examination,a variety of imaging techniques and clinical follow-up examination,follow-up time for more than half a year.Results：Sixteen cases showed tumor recurrence and metastasis,PET/CT diagnosis of gastric remnant recurrence sensitivity was 81.2%,specificity was 100%,accuracy was 97.3%.SUVave of recurrent lesions was 4.4±1.2,SUVave of anastomotic inflammatory lesions was 2.6±0.5,difference was statistically significant（t=3.9370,P =0.0005）.PET/CT diagnosis of gastric cancer metastasis：sensitivity was 94.1%,specificity was 96.7% and accuracy was 95.5%.Twenty-six cases who had received PET/CT examination for two or more than two times,15 cases who received the first PET/CT examination and 6 cases showed improvement after radiotherapy and chemotherapy.These patients survived after 6 months to 2 years of follow-up;PET imaging in 9 cases after treatment showed no significant change in conditions or the emergence of new lesions,the patient survival time was 3 months to 1 year.Conclusions：18F-FDG PET/CT in the postoperative recurrence and metastasis of gastric cancer have a good diagnostic value,and have certain value in monitoring postoperative chemotherapy of gastric cancer.