A Clinical Study On Diagnosis And Treatment And Prognosis Of ¹⁸F-FDG PET/CT Of Patients With Hilar Cholangocarcinoma

Objective1.To explore the value of ¹⁸F-FDG PET/CT image on the Differential Diagnosis of Hilar Cholangocarcinoma and Primary Sclerosing Cholangitis ?PSC? .2. To explore the value of clinical staging and Resectable Evaluation of ¹⁸F-FDG PET/CT.3.To explore the prognosis value of ¹⁸F-FDG PET/CT image of patients who underwent Radical Resection of Hilar Cholangocarcinoma.Methods1 .?1? A retrospective analysis was done on the clinical data of the patients who suffered from Hilar Cholangocarcinoma and Primary Sclerosing Cholangitis. All the patients attended to the Department Of Hepato-pancreato-biliary Surgical Oncology,PL A General Hospital from September 2014 to September 2016,and underwent ¹⁸F-FDG PET/CT.?2?A11 the results of ¹⁸F-FDG PET/CT and Maximal Standardized Uptake Value ?SUVmax ? were achieved and analysed. The value on PET/CT of diagnosis and resectability were evaluated. SUVmax>3.5 was the criterion of positive criterion.?3?The result of PET/CT image combined with serum tumor markers CA19-9 to diagnosis Hilar Cholangocarcinoma. If both were abnormal, then the joint diagnosis was positive ?hilar cholangiocarcinoma?.?4?All data were analysed by SPSS20.0,and P values of less than 0.05 was statistically significant.2. A retrospective analysis was done on the clinical data of the patients who suffered from Hilar Cholangocarcinoma and underwent ¹⁸F-FDG PET/CT and received operation from January 2014 to September 2016. The survival curve was calculated by Kaplan-Meier; the correlation analysis of what effected overall survival time ? OS?and disease-free survival time ?DFS? were analysed by COX regression model.Results1.?1? 100 patients were enrolled in this study. The sensitivity, specificity and accuracy of ¹⁸F-FDG PET/CT in differential diagnosis of hilar cholangiocarcinoma and primary sclerosing cholangitis were 91.7%?80% and 87.7%,respectively. ?2? The sensitivity,specificity and accuracy of ¹⁸F-FDG PET/CT combined with CA19-9 in differential diagnosis of hilar cholangiocarcinoma and primary sclerosing cholangitis were 60%?76.7% and 65.5%, respectively. The difference of CA19-9 between malignant and benign lesions was statistically significant?P=0.001?.?3? The accuracy of ¹⁸F-FDG PET/CT of Bismuth-Corlette Classification in patients with hilar cholangiocarcinoma was 81.8% ?45/55?, and 8 of the 10 cases which gained a wrong classification were underestimated the extent of intrahepatic bile duct invasion, the other 2 were overrestimated.?4? The sensitivity, specificity and accuracy of ¹⁸F-FDG PET/CT for the detection of local lymph node metastasis were 87.5%?72.4% and 79.2%?,respectively. ?5? The resectability evaluation of ¹⁸F-FDG PET/CT and intraoperative exploration showed no significant difference??2=0.009, P=0.927>0.05?.2.?1? In this part, 43 patients who were treated with radical resection were enrolled.OS and DFS in patients with high SUVmax were significantly lower than those with low SUVmax ?P<0.05?;?2?SUVmax was an independent risk factor for postoperative OS and DFS in patients with hilar cholangiocarcinoma ?P<0.05?.Conclusions1.¹⁸F-FDG PET/CT has significant value in differential diagnosis of hilar cholangiocarcinoma and primary sclerosing cholangitis. The sensitivity, specificity and accuracy were high.2. In the preoperative diagnosis, ¹⁸F-FDG PET/CT had high accuracy in tumor staging and metastasis of patients with hilar cholangiocarcinoma. and has important application value for selection of operation method.3. SUVmax was an independent prognostic factor for the survival of patients with radical resection of hilar cholangiocarcinoma.