目的: 探讨PET－CT 对¹²⁵ I 粒子植入术后胰腺癌的预后评估价值。方法: 胰腺癌病人21 例，初诊时
经PET－CT 检查确定为显像阳性病灶。放射性粒子术中植入后2mo 行PET－CT 结合CA 199 检测评价胰腺癌治
疗后病灶残留状况，之后每mo 进行常规影像学结合肿瘤标志物检查等进行随访，随访到5mo 的结果作为肿瘤
恢复或复发的标准。结果: ¹²⁵ I 粒子植入术后2mo，CA 199 检测: 49．3±16．7KU/L，与术前311．8±126．4KU/L 比较
有显著性差异( P＜0．05) ; PET－CT 示: 原21 例阳性病灶，13 例无残留，8 例有边缘扩大，其中5 例进行粒子补种;
随访5mo，证实125 I 粒子植入准确，恢复13 例( 包括术后2mo PET－CT 示: 无残留12 例，残留: 1 例) ; 复发8 例( 包
括术后2mo PET－CT 示: 无残留1 例，残留: 7 例) 。PET－CT 在¹²⁵ I 粒子植入后早期判断其是否复发灵敏度:
87．5%，特异度: 92．3%。恢复的13 例CA 199 均降至正常范围; 2 月时有残留病灶的8 例，其中5 例因进行了粒
子补种，故5mo 时该值无明显变化。两组CA 199 前后比较均有显著性差异( P＜0．05) 。结论: 18 F－FDG PET/CT
对显像阳性的胰腺癌¹²⁵ I 粒子植入术后坏死灶、残留灶的区分有较高的辨别能力，能够较早、较好地评价疗效，及
早明确复发并及时改善预后。

Objective: To determine the prognostic value on PET－CT in pancre－atic cancer by125 I
seeds implantation．Methods: 21 patients with pancreatic cancer are is determined positive lesions by
PET－ CT imaging examination at initial diagnosis． Ｒadioactive particles in surgery implanted，two
months after treatment condition，CA 199 combined PET－CT evaluation were determined to evaluate
pancreatic residual and no residue， then monthly routine imaging( CT or MＲI) examination combined
with clinical symptoms and signs of tumor markers，etc．the standard results in five months after follow
up as tumor restore or recurrence．Ｒesult: The implantation of particles in February125 I， the line CA 199
testing，almost approaching normal 49．3 ± 16．7 KU/L． The result had significant difference compared
with preoperative 311．8±126．4 KU/L; 21 cases tumor for PET－CT examination has 13 cases no residu
－al lesions，8 cases lesions edge to expand; 5 cases were particles replant; follow－up in five months，
confirmed 13 patients restore( 2 M PET－CT show 1 case residual and 12 cases no residual) ，confirming
8 cases recurrence( 2 M PET－CT show 7 case residual and 1 cases no residual) ．The effect of PET－CT
on125 I seed implantation is determined whether there is residual disease after sensitivity 87．5%， specificity
was 92．3%．13 patients with restore disease CA 199 decreased to the normal range， there are eight
cases of residual disease，5 cases were due to particle replant， so the value is no significant change in
the five months．Before and after CA 199 were significantly different．Conclusion: 18 F－FDG PET /CT
imaging was positive for pancreatic cancer125 I seed implantation with residual tumor necrosis distinction
has a higher ability to distingui－sh better able to evaluate the efficacy，and to provide guidance for further
treatment early recurrence clear and timely manner to improve prognosis．

Ｒ735．9

 收稿日期: 2017－08－09; 修回日期: 2017－10－21
基金项目: 内蒙古医科大学附属医院一般科研项目( NYFY YB2014005)
作者简介: 张剑( 1980－) ，男，蒙古族，内蒙古医科大学附属医院主治医师，医学博士。
通讯作者: 王宏伟，主任医师，E－mail: 1148430923@ qq．com 内蒙古医科大学附属医院放疗科， 010050