肺良性病变的PET/CT显像及其与葡萄糖转运蛋白的关系

Correlations of glut expression to PET/CT imaging in lung benign lesion patients

目的 研究肺良性病变的PET/CT显像特点及其与葡萄糖转运蛋白表达的关系.方法 48例肺良性病变患者术前行PET/CT检查,分析良性病变的PET/CT显像,检测Glut-1、3的表达,并作相关分析.结果 48例肺良性病变中,33例结核有24例发生于两肺上叶尖后段或下叶背段,9 例发生在两肺上叶前段或下叶基底段,均为结核的好发部位.9例炎性假瘤发生于两肺上叶前段或下叶基底段,也在其好发部位.SUVave为0.74~6.87,平均为2.78±1.77.SUVave与病变大小（Dmax）无相关性（P＞0.05）.17例肺良性病变表现为高氟代脱氧葡萄糖（FDG）摄取（SUVave＞2.5）,其中肺结核15例,肺炎性假瘤及肺隐球菌性肉芽肿各1例,其病灶放射性浓聚不均一.Glut-1的表达与FDG摄取成正相关性（r=0.70,P＜0.01）.Glut-3的表达与FDG摄取成正相关性（r=0.75,P＜0.01）.Glut-3的表达明显高于Glut-1的表达.结论 肺良性病变亦可出现FDG高摄取,仔细分析病变位置、放射性分布有助于鉴别诊断.肺良性病变中的炎性细胞及其表达的Glut-3是影响肺良性病变PET/CT显像的重要因素.

Objective This study was to discuss the relationship between expression of glucose transporter and PET/CT imaging in lung benign lesion patients. Methods forty-eight Lung benign lesion patients received PET/CT scan before operation. The expression of Glut-l,3 was studied by immunohistochemistry. The relationship among these factors was investigated. Results In forty-eight lung benign lesions, twenty-four of thirty three tuberculomas（TB）lesions distributed in double lung superior apical back segment or lower lamina back segment, nine tuberculomas distributed in double lung superior anterior segment or lower basic segment. Most of the TB lesions were distributed in frequent region, nine psedotumor distributed double lung superior arterior segment or lower basic segment. Correlations were not found between SUVave （2.78 ±1. 77）and lesion size （Dmax）. seventeen patients showed high uptake of FDG（SUVave〉2.5）,including 15 tuberculosis, 1 cryptococcosis, 1 inflammatory pseudotumor, the radioactivity distribution in these lesions were not uniform. Glut-1 expression was positively correlated to SUVave （r= 0.70, P〈 0.01 ）. Glut-3 expression was positively correlated to SUVave（r= 0. 75,P〈0. 01）. the Glut-3 expression was higher than Glut 1 in lung benign lesion patients. Conclusion Some benign lesions commonly cause an increase in FDG uptake. It is helpful for diagnosis of benign lesions by analysing the position and radioactivity distribution of the lesions on the images. The inflammatory cells and the Glut-3 expressed by them might play an important role in the PET/CT imaging.