^(18)F-FDG PET/CT标准化摄取值与鼻咽癌临床分期和病理类型的关系

Analysis of standard uptake values of ^(18)F-FDG PET/CT in relation to pathological classification and clinical staging of nasopharyngeal carcinoma

目的探讨18F-脱氧葡萄糖(18F-FDG)PET/CT显像的标准化摄取值(SUV)与鼻咽癌临床分期和病理类型的关系。方法初治鼻咽癌患者32例(均经病理组织学确定),所有患者皆行18F-FDGPET/CT显像,沿病灶周边勾画感兴趣区,计算鼻咽部和颈部病灶的SUV值,病灶大小=(长轴+短轴+纵轴)/3。结果(1)Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者的平均SUV值分别为4.50±0.42、6.65±1.74、7.33±1.50和8.24±2.16,各期SUV值无差异(P>0.05);(2)T1、T2、T3、T4的SUV值随T分期的增加逐渐增大,分别为2.56±1.05、3.72±0.60、6.87±1.07和9.70±0.70,各分期间差异有统计学意义(P<0.05);(3)N1、N2、N3之间的SUV值无差异(P>0.05),但直径>6cm的淋巴结的SUV值(5.02±1.91)较直径≤6cm的淋巴结SUV值(3.48±1.81)大(P<0.05);(4)鼻咽癌低分化鳞癌患者SUV值为5.58±1.48,较未分化癌患者SUV值8.41±1.71低(F=1.336,P=0.000)。结论(1)鼻咽癌临床分期与SUV值无相关性;(2)鼻咽癌T分期与SUV值有相关性;N分期与SUV值无相关性,但直径>6cm的淋巴结与直径≤6cm的淋巴结与SUV值具有相关性;(3)鼻咽癌18F-FDGPET/CT显像的癌细胞SUV值与其病理分化程度有相关性。

Objective To explore the relation of the standard uptake values （SUV） of 18F-fluorodexygl-gucose （18F-FDG） PET/CT and the pathological classification and clinical staging ofnasopharyngeal carcinoma （NPC）. Methods Whole body 18F-FDG PET imaging was performed in 32 patients with pathologically confirmed NPC, who received no previous treatment. The regions of interest （ROI） covering the pharyngeal and cervical lesions were defined along the margins of the lesion, and the lesion volume and the SUVs were calculated. Result The SUVs in stage Ⅰ,Ⅱ,Ⅲ, and Ⅳ patients were 4.50±0.42, 5.62± 1.44, 7.33±1.50, and 8.24±2.16, respectively, showing significant differences between them （P〈0.05）. In patients in stage T1, T2, T3, and T4, the SUVs increased significantly in advanced stageds （2.56±1.05, 3.72±0.60, 6.87±1.07, and 9.70±0.70, respectively, P〈0.05）. The SUVs were not significantly different in patients in stages N1, N2, and N3, differed significantly between lymph nodes 〉6 cm in size and those ~〈 6 cm （5.92± 1.51 vs 3.48± 1.31, P〈0.05）. The SUV in poorly differentiated squamous carcinoma was significantly lower than that in undifferentiated carcinoma （5.58±1.48 vs 8.41±1.71, F=1.3323, P=0.01）. Conclusion The SUV is not associated with the clinical staging of NPC, but is correlated to the T staging of NPC. Though irrelevant to the N staging of NPC, the SUV is correlated to the size of the lymph nodes, and also related to the degree of differentiation of NPC.