目的：探讨18 F-脱氧葡萄糖正电子发射显影/电子计算机断层扫描成像（18 F-FDG-PET）在妊娠绒毛膜癌临床诊疗中的应用价值。方法对2例妊娠绒毛膜癌患者多次同时行18 F-FDG-PET检查与动态血绒毛膜促性腺激素（β-HCG）监测，分析双肺、肝脏及盆腔的代谢异常增高转移性病变情况。结果1例患者发现双肺、肝脏及盆腔多处转移病灶，经EMA-CO方案化疗后动态血β-HCG渐转正常，18 F-FDG-PET显示多处病灶趋渐转阴。另1例经化疗后复发，18 F-FDG-PET显示原发癌灶无活性，但血β-HCG稍增高，行子宫全切除术，病理诊断提示妊娠绒毛膜癌，活性细胞存在，判定18 F-FDG-PET呈假阴性。术后持续随访，血β-HCG均为阴性。结论18 F-FDG-PET在妊娠绒毛膜癌临床诊疗中了解原发灶与转移灶特点，评估癌细胞活性具有较高的应用价值。结合血β-HCG监测，可降低18 F-FDG-PET假阳性和假阴性，为临床上妊娠绒毛膜癌的诊疗提供可靠依据。%Objective To investigate the clinical value of 18 F-deoxyglucose positron emission tomography/computer tomo-graphy ( 18 F-FDG-PET) in diagnosis and treatment of choriocarcinoma. Methods The 18 F-FDG-PET with simultaneously monitoring serum beta-human chorionic gonadotrophin (β-HCG) was carried out on 2 cases with choriocarcinoma. The increased metabolic abnor-malities in metastatic lesions of lung, liver and pelvic were observed. Results In one patient, 18 F-FDG-PET revealed the primary cho-riocarcinoma associated with pulmonary, liver and pelvis cavity metastases. The level of serumβ-HCG decreased to normal level gradu-ally and the SUVs of multiple lesions followed a normal distribution after EMA-CO chemotherapy. For another recurrence patient, serumβ-HCG increased and pathology diagnosis revealed that few viable cells existed by undergoing radical hysterectomy, but 18 F-FDG-PET detected no uptake. Conclusion 18 F-FDG-PET is useful in diagnosis and treatment of choriocarcinoma by detecting the primary and metastasis sites, and possesses higher value in assessing cytoactive. Simultaneously monitoring serum β-HCG can decrease the false positive rate and false negative rate of 18 F-FDG-PET.
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