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目的探讨18F-FDG PET/CT显像在宫颈癌初诊患者中的应用价值。方法回顾性分析43例经病理学证实的FIGO分期ⅠB期及以上的宫颈癌患者的临床资料和治疗前10天内18F-FDG PET/CT及同机增强CT的影像资料。结果 PET/CT与同机增强CT诊断宫颈癌原发灶的灵敏度分别为100%、86.0%,差异有统计学意义(χ2=4.479,P=0.034)。分别以患者和淋巴结分区为单位计算,18例患者伴区域淋巴结转移,36例手术患者共切除的351组区域淋巴结中,病理学证实存在27组转移淋巴结,PET/CT灵敏度均为77.8%,同机增强CT的灵敏度为63.2%,48.1%。以淋巴结分区为单位计时,两者灵敏度差异有统计学意义(χ2=5.082,P=0.024)。43.5%患者依据PET/CT影像资料更改了临床治疗方案,其中3例发现远处转移灶。结论18F-FDG PET/CT不但可准确判断宫颈癌原发灶的侵犯范围,而且可以检出淋巴结及远处器官转移,在宫颈癌诊断及指导临床治疗决策等方面均有重要的应用价值。
Objective To investigate the value of 18F-FDG PET / CT in the diagnosis of newly diagnosed cervical cancer. Methods We retrospectively analyzed the clinical data of 43 cases of pathologically confirmed cervical cancer with FIGO staging ⅠB and above and the imaging data of 18F-FDG PET / CT and simultaneous enhanced CT within 10 days before treatment. Results The sensitivity of PET / CT and CT in the diagnosis of primary cervical cancer was 100% and 86.0%, respectively. The difference was statistically significant (χ2 = 4.479, P = 0.034). The sensitivity of PET / CT was 77.8% in pathological analysis of 27 metastatic lymph nodes in 351 patients with regional lymph node metastases in 18 patients with regional lymph node metastasis and 36 patients with surgical resection, respectively. Machine enhanced CT sensitivity was 63.2%, 48.1%. The lymph node count as a unit of time, the difference between the two sensitivities was statistically significant (χ2 = 5.082, P = 0.024). 43.5% of patients based on PET / CT image data to change the clinical treatment options, of which 3 cases found distant metastases. Conclusion 18F-FDG PET / CT not only can accurately determine the extent of the primary tumor of cervical cancer, but also can detect the metastasis of lymph nodes and distant organs. It has important value in the diagnosis and guidance of clinical treatment of cervical cancer.