目的 探讨18F-脱氧葡萄糖(Fluorine-18 fluorodeoxyglucose,FDG)正电子发射计算机断层显像(Positron Emission Computer Tomography,PET/CT)在肝细胞肝癌治疗后甲胎蛋白(AFP)升高患者中的应用价值.方法 对30例肝细胞肝癌治疗后AFP升高的患者临床资料进行回顾性分析,18F-FDG PET/CT全身显像探测有无复发或/和转移灶,并以病理结果和随访结果为金标准,计算其诊断的灵敏度、特异性、阳性预测值和阴性预测值.随访9～14个月.结果 18F-FDG PET/CT诊断复发或/和转移25例,其中1例经针吸活检病理证实为肝腺瘤,1例经手术证实为第二原发癌;18 F-FDG PET/CT诊断阴性5例,其中1例在随访第5个月时证实为肝内多发转移.18F-FDG PET/CT诊断肝细胞肝癌术后复发或/和转移的灵敏度95.8％(23/24),特异性66.7％ (4/6),阳性预测值92％ (23/25),阴性预测值80％ (4/5).结论 18 F-FDG PET/CT全身显像能可靠鉴别AFP升高的肝细胞肝癌治疗后患者有无转移或复发,准确探测复发和转移灶,改变治疗方案,联合AFP的动态变化过程,能进一步提高诊断的可靠性.%Objective To evaluate the value of 18F-FDG PET/CT in monitoring patients with increased AFP after hepatocellular carcinoma (HCC) therapy.Methods We retrospectively analyzed the clinical data of 30 HCC patients with increased AFP after HCC therapy.18F-FDG PET/CT was used to monitor the recurrence or metastasis.The results of PET/CT imaging were compared with pathological examination and clinical follow-up results to estimate its sensitivity,specificity,positive predictive value and negative predictive value.The duration of the clinical follow-up varied from 9 months to 14 months.Results 18F-FDG PET/CT diagnosed 25 positive,but two of the 25 were proven as false positive by pathology.18 F-FDG PET/CT diagnosed the other 5 negative,but one of the 5 was proven as false negative.The sensitivity,specificity,positive predictive value and negative predictive value of 18 F-FDG PET/CT were 95.8％ (23/24),66.7％ (4/6),92％ (23/25),and 80％ (4/5),respectively.Conclusion 18F-FDG PET/CT imaging can reliably identify and detect recurrences or metastasis in HCC patients with increased AFP and help to change the treatment plans.Combination with the dynamic measurement of AFP,it can further enhance the diagnostic accuracy rate.
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