Mataki Yuko, Shinchi Hiroyuki, Kurahara Hiroshi, Maemura Kosei, Noma Hidetoshi, Natsugoe Shoji, Takao Sonshin
Dept. of Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Gan To Kagaku Ryoho. 2009 Dec;36(13):2516-20.
The purpose of this study was to estimate the usefulness of positron emission tomography (PET) in dividing the uptake with and without the main tumor for the treatment of patients with pancreatic cancer.
Ninety-eight patients with primary pancreatic cancer were evaluated with 18F-FDG-PET. For the main tumor, the maximum standardized uptake values(SUVmax)were compared with clinicopathological factors and analyzed. We examined the site of accumulation and the rate of malignancy without the main tumor.
For the accumulation of FDG in the main tumor, the high SUVmax level was significantly correlated with T-category in TNM classification (p=0. 003), tumor invasive size (>3 cm) (p <0. 001), CA19-9 levels>100 U/mL) (p=0. 002). The overall survival of the group in which SUVmax was less than 7. 5 was better than that of the group in which it was more than 7. 5 (p=0. 03). Meanwhile, 58 patients (59%) showed the accumulation of FDG except for the main tumor. Lymph node uptake was shown in 44% of them. As for visceral accumulation, the liver was 11, lung 10, pancreas except main tumor 9, thyroid 7, peritoneal wall 3, colon 2, gall bladder 2, and bone 1. As for the rate of malignancy among them, the liver was 100%, lung 50%, pancreas except main tumor 0%, thyroid 29%, peritoneal wall 67%, colon 50%, gall bladder 50%, and bone 0%.
We conclude that FDG-PET is a useful tool for predicting the prognosis in pancreatic cancer, and for detection of distant metastases and hidden malignant disease. FDG-PET has an important clinical impact on the selection of proper treatment.
本研究旨在评估正电子发射断层扫描(PET)在区分胰腺癌患者治疗中主肿瘤有无摄取方面的实用性。
对98例原发性胰腺癌患者进行18F-FDG-PET评估。对于主肿瘤,比较其最大标准化摄取值(SUVmax)与临床病理因素并进行分析。我们检查了无主肿瘤时的积聚部位和恶性率。
对于主肿瘤中FDG的积聚,高SUVmax水平与TNM分类中的T分期(p = 0.003)、肿瘤浸润大小(>3 cm)(p <0.001)、CA19-9水平>100 U/mL(p = 0.002)显著相关。SUVmax小于7.5的组的总生存期优于大于7.5的组(p = 0.03)。同时,58例患者(59%)在主肿瘤外显示有FDG积聚。其中44%有淋巴结摄取。关于内脏积聚,肝脏11例,肺10例,除主肿瘤外的胰腺9例,甲状腺7例,腹膜壁3例,结肠2例,胆囊2例,骨1例。其中的恶性率方面,肝脏为100%,肺为50%,除主肿瘤外的胰腺为0%,甲状腺为29%,腹膜壁为67%,结肠为50%,胆囊为50%,骨为0%。
我们得出结论,FDG-PET是预测胰腺癌预后、检测远处转移和隐匿性恶性疾病的有用工具。FDG-PET对选择合适的治疗方法具有重要的临床意义。