Primeri bilinmeyen maligniteli hastaların değerlendirilmesinde 18F-FDG PET/BT’nin rolü

Yıl 2020, Cilt: 13 Sayı: 1, 119 - 127, 21.01.2020

Aziz Gültekin , Tarık Şengöz

https://doi.org/10.31362/patd.655998

Öz

Amaç: Bu retrospektif çalışmanın amacı, 18F-FDG PET/BT'nin primeri bilinmeyen kanserli hastalarda primer kanseri saptamadaki etkinliğini araştırmak ve PET/BT sonuçlarını histopatolojik sonuçlarla karşılaştırmaktır.
Gereç ve Yöntem: Kliniğimize primeri bilinmeyen malignite öntanısıyla başvuran ve 18F-FDG PET/BT taraması yapılan 134 hastanın bilgileri hastane bilgi sisteminden incelendi. Bu hastalardan histopatolojik incelemesi tamamlanmış olan 114 tanesinin PET/BT taramaları iki deneyimli nükleer tıp uzmanı tarafından yeniden değerlendirildi. PET/BT sonuçları histopatolojik bulgularla karşılaştırıldı. 18F-FDG PET/BT’ nin sensitivite, spesifite ve doğruluk oranları hesaplandı. Bu hasta serisinde doğrulanmış primeri bilinmeyen kanser oranı hesaplandı.
Bulgular: Çalışmamıza 56 kadın, 58 erkekten oluşan, yaşları 13-90 arasında 114 hasta dahil edildi. Hastaların ortalama yaşı: 60,53±17,04 yıl idi. Histopatolojik olarak 73 (%64) hasta malign, 41 (%36) hasta benign idi. 18F-FDG PET/BT’ye göre primer veya metastatik olarak toplam 83(%73) hasta malign, 31(%27) hasta benign olarak değerlendirildi. 18F-FDG PET/BT histopatolojik olarak malignitesi kanıtlanmış 73 hastanın 65’inde(%89) primer odağı doğru tespit edebildi. 18F-FDG PET/BT, 73 hastanın 8’ inde (% 11) primer tümör bölgesini tanımlayamadı. Bu sekiz hastanın ikisi plazma hücreli myelom, biri multible myelom ve bir hasta lenfoma idi. Bu nedenle 4(%6) hasta doğrulanmış primeri bilinmeyen kanser olarak kabul edildi. Genel olarak, tanısal doğruluk %78, duyarlılık%89, özgüllük%56, pozitif öngörü değeri% 78,5, negatif öngörü değeri% 74 olarak bulundu.
Sonuç: 18F-FDG PET/BT primeri bilinmeyen malignite hastalarında tüm vücut tarama avantajı ve sensitivitesinin yüksek olması nedeniyle primer kanser odağını belirlemede oldukça başarılıdır.

Anahtar Kelimeler

Primeri bilinmeyen kanser, florodeoksiglukoz, pozitron emisyon tomografisi

Destekleyen Kurum

Proje desteğinden faydalanılmadı.

Proje Numarası

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Teşekkür

Çıkar ilişkisi: Yazarlar çıkar ilişkisi olmadığını beyan ederler.

The role of 18F-FDG PET/CT in the evaluation of patients with cancer of unknown primary

Öz

Purpose: The aim of this retrospective study is to investigate the efficacy of 18F-FDG PET/CT in detecting primary cancer in patients with cancer of unknown primary and to compare PET/CT results with histopathological results.
Materials and Methods: The data of 134 patients who presented to our clinic with the diagnosis of malignancy with unknown primary and underwent 18F-FDG PET/CT scan were examined from the hospital information system. PET CT scans of 114 of these patients, whose histopathological examination was completed, were re-evaluated by two experienced nuclear medicine specialists. PET/CT results were compared with histopathological findings. Sensitivity, specificity and accuracy of 18F-FDG PET/CT were calculated. In this patient series, the ratio of the confirmed CUP was calculated.
Results: A total of 114 patients (56 women, 58 men) aged 13-90 years were included in the study. The mean age of the patients was 60.53 ± 17.04 years. Histopathologically, 73 (64%) patients were malignant and 41/114 (36%) patients were benign. According to 18F-FDG PET/CT, 83 (73%) patients were evaluated as malignant and 31 (27%) patients as benign or primary or metastatic. 18F-FDG PET/CT was able to accurately detect primary focus in 65 (89%) of 73 patients with histopathologically confirmed malignancy. 18F-FDG PET / CT could not identify the primary tumor site in 8 (11%) of 73 patients. Two of these eight patients were plasma cell myeloma, one was multible myeloma and one patient was lymphoma. Therefore, 4 (6%) patients were accepted as confirmed cancer of unknown primary. Overall, the diagnostic accuracy was found to be 78%, sensitivity 89%, specificity %56%,positive predictive value %78.5, negative predictive value%74.
Conclusion: 18F-FDG PET/CT is highly successful in determining the primary cancer focus in patients with CUP due to its full body scanning advantage and high sensitivity.

Anahtar Kelimeler

cancers of unknown primary, fluorodeoxyglucose

Proje Numarası

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Kaynakça

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