PET/CT显像淋巴瘤病灶^(18)F-FDG摄取程度与肿瘤增殖性抗原Ki-67相关性研究

Study of the Correlation between ^(18)F-FDG Uptake Value of Lymphoma Lesion and Tumor's Proliferative Antigen Ki-67

目的:通过对比50例不同病理亚型的淋巴瘤肿瘤增殖性抗原Ki-67表达水平与^(18)F-FDG PET显像病灶^(18)F-FDG浓聚程度来探讨两者之间相关性。方法:收集50例经病理及免疫组化证实的淋巴瘤病例,每个病例均有酶标肿瘤增殖性抗原Ki-67染色免疫组化报告,病理检查前或后常规行PET/CT检查。病理分型均采用WHO分类标准,并对非霍奇金淋巴瘤例按WF分类标准对其进行大小细胞类型归类。Ki-67酶标染色结果统一采用分级方法:核抗原染色阳性细胞百分数为0～5%,表示为微弱阳性(+/-);百分数为5%～20%,表示为弱阳性(+);百分数为20%～50%,表示为中阳性(++);百分数大于50%,表示为强阳性(+++)。PET/CT影像上,病灶^(18)F-FDG摄取程度采用半定量分析方法,计算出病灶平均标准化摄取值SUV(SU Vave)。利用统计软件(SPSS13.0)计算不同病理亚型的病灶^(18)F-FDG摄取值(以(?)±s表示),并对大、小细胞类型淋巴瘤的FDG摄取值差异显著性行t检验;对所有病灶Ki-67表达水平与^(18)F-FDG摄取程度两者之间采用Spearman方法进行相关性分析。结果:大细胞来源的淋巴瘤^(18)F-FDG摄取值远高于小细胞来源的淋巴瘤^(18)F-FDG摄取值,特别是B系大小细胞不同类型淋巴瘤,其^(18)F-FDG摄取值差异性更显著;Ki-67表达水平同结性与结外病灶^(18)F-FDG摄取值两者存在显著相关性,r值分别为0.750和0.843。结论:反映肿瘤增殖活性的Ki-67与淋巴瘤病灶^(18)F-FDG摄取程度有明显关系,Ki-67表达程度较高的大细胞性进展性淋巴瘤,其病灶^(18)F-FDG摄取值很高,而Ki-67表达程度较低的小细胞性低度恶性淋巴瘤,其^(18)F-FDG摄取值较低。

Purpose： To discuss the correlation between Ki- 67 level which represented tumor＇s prolif-eration antigen in immunohistochemical staining and the FDG uptake value in PET/CT imaging by comparing 50 cases of different subtypes of lymphomas.Methods： Fifty cases of lymphomas confirmed by pathology and immunohistochemistry were labeled Ki - 67 staining and performed PET/CT examination. All lymphoma cases were sorted according to the WHO classification,and NHL were divided into 2 groups （large cell group and small cell group） by using Working Formulation. The reports of Ki - 67 staining were described as follows： the expressed positive cell in nuclear antigen staining accounted for 0 - 5% as very weak （ ＋ / - ） ; 5% - 20% as weak （ ＋ ） ; 5% - 20% as moderate（ ＋ ＋ ） ; 〉 50% as strong（ ＋ ＋ ＋ ）. Semi - quantitative analysis was used to calculate the average standard uptake value（SUVave） of the FDG uptake of lesions in PET/CT imaging. And statistics software（SPSS13.0）was used as follow： the FDG uptake values of different subtype of lymphomas were described as ^-x ± s ; a student t test between the large cell lymphoma and small cell lymphoma was taken to prove the significant difference exist; and the correlation between the Ki - 67 level and FDG uptake of lesion was evaluated by Spearman analysis. Result： The FDG uptake values of large cell origin lymphomas were significant higher than that of small cell origin lymphoma, especially in B cell lymphoma; there was significant correlation between Ki - 67 level and FDG uptake value in lymph nodal or extranodal lesions. Conclusions： Ki - 67 which reflected tumor proliferative activity was clearly related to the FDG uptake value of lymphoma lesions. The large cell progressive lymphoma, which expressed high Ki - 67 level, resulted in intense FDG uptake; the small cell indolent lymphoma, which low expressed Ki- 67, the FDG uptake value decreased correspondingly.