摘要
背景与目的:原发性肝癌经动脉导管栓塞化疗(transcatheterarterialchemo-embolization,TACE)联合射频消融(radiofrequencyablation,RFA)治疗后,CT扫描对判断是否有肿瘤残留存在一定的困难,而18FDG-PET/CT(18-fluorodeoxyglucose-positronemissiontomograply/CT)在判断肿瘤残留上具有优势。本研究对13例原发性肝癌经TACE联合RFA治疗周后,采用CT和18FDG-PET/CT检查是否存在肿瘤残留,分析CT和18FDG-PET/CT在判断肿瘤残留上的差异,并根据18FDG-PET/CT的结果指导肿瘤治疗。方法:本组13例原发性肝癌患者共有18个病变,肿瘤最长直径为0.8～16.0cm。12例为初治病例;1例为肝癌手术后复发,肝内共发现有3个病变。经过TACE联合RFA治疗后2～3周,对比CT和18FDG-PET/CT检查的结果;如发现有肿瘤残留,在2～3周内对其进一步行RFA治疗。结果:13例患者经一次TACE联合一次RFA治疗2～3周,经病变区域活检及数字减影血管造影等检查发现11例有部分肿瘤残留,肿瘤残留最长直径为1.0～2.1cm;CT增强扫描检查检出5例,18FDG-PET/CT检出有10例残留,CT与18FDG-PET/CT检出率分别为45.4%及90.9%。根据检查结果,在2～3周内经过第二次RFA治疗后,18FDG-PET/CT检查发现10例患者肿瘤无残留,另1例6周后复查18FDG-PET/CT发现肝内病变未控,患者带瘤生存。结论:原发性肝癌经TACE联合RFA治疗以及手术后,18FDG-PET/CT对判断肿瘤残留以及根据检查结果指导RFA治疗较CT检查具有更大的优势。
BACKGROUND ＆ OBJECTIVE： Judging tumor residue of hepatocellular carcinoma （HCC） after treatment of transcatheter arterial chemo-embolization （TACE） combined with radiofrequency ablation （RFA） by computed tomography （CT） scan is difficult; while 18-fluorodeoxyglucose- positron emission tomography/CT （^18SFDG-PET/CT） has some advantages in this aspect. This study was designed to compare the results of ^18FDG-PET/CT and CT scan in judging tumor residue of HCC after treatment of TACE combined with RFA, and to guide following treatment according to the result of ^18FDG-PET/CT. METHODS： Thirteen HCC patients with 18 lesions, 0.8- 16.0 cm in diameter, were treated in Cancer Center of Sun Yat-sen University from Nov. 2002 to Jun. 2003. Of the 13 patients, 12 were naive patients with 15 lesions; 1 was relapsed with 3 lesions 1 year after hepatectomy. The results of CT and ^18FDG-PET/CT of the 13 patients 2-3 weeks after treatment of TACE combined with RFA were compared. If tumor residue was dictated, a further RFA treatment would be applied within 2-3 weeks. RESULTS： Of the 13 HCC patients that received 1 course of TACE combined with RFA, 11 had tumor residues which were conformed by fine needle biopsy and digital substraction angiography （DSA）. CT only detected 5 positive cases; however, ^18SFDG-PET/CT detected 10 positive cases. Positive rate of CT was 45.4%, and that of ^18SFDG-PET/CT was 90.9%, According to the results of ^18SFDG-PET/CT of the 11 patients, after the second course of RFA, 10 patients had no tumor residue; 1 patient survived with uncontrolled lesion 6 weeks after treatment. CONCLUSION; ^18SFDG-PET/CT is better than CT in judging tumor residue of HCC after treatment of TACE combined with RFA or surgery, and in guiding further treatment of HCC.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2005年第9期1118-1123,共6页
Chinese Journal of Cancer
作者简介
通讯作者：吴沛宏,Tel：86—20—87343272 Fax：86—20—87343272 E—mail：wupeihong@yahoo．com
