18F-FDG符合线路显像诊断鼻咽癌的价值

Clinical value of 18F-FDG coincidence imaging for diagnosis of nasopharyngeal carcinoma

目的探讨18F—FDG符合线路显像在鼻咽癌诊断中的价值。方法回顾性分析45例首发鼻咽癌患者资料，均经病理检查证实，治疗前行18F-FDG符合线路显像，计算鼻咽部病灶的放射性计数与全小脑放射性平均计数比（即T／NT）值及肿瘤体积。采用配对r检验比较19F—FDG符合线路显像与EB病毒相关抗体检测方法阳性率差异；对T／NT值与肿瘤体积行Pearson相关分析；使用ROC曲线确定T／NT值及肿瘤体积的最佳界值；并采用t检验和秩和检验对比分析不同分组方法组间T／NT值及肿瘤体积的差异。结果18F．FDG符合线路显像阳性率为97．78％（44／45），EB病毒相关抗体总阳性率为95．56％（43／45），两者差异无统计学意义（X2=1．33，P〉0．05）。鼻咽部原发病灶T／NT值为2．439±1．119，肿瘤体积为（7．311±8．280）cm3，两者呈正相关（r=0．463，P〈0．05）。ROC曲线确定T／NT值的最佳界值为2．396，肿瘤体积的最佳界值为7．348cm3。首发症状有无涕血组间、有无面部麻木组间及各病理类型组间TINT值差异均有统计学意义（2．847±1．254与2．082±0．863、2．8554-1．261与2．1344-0．913、2．266±0．997与2．971±1．351，t=一2．409、一2．225和一2．018，P均〈0．05）；首发症状有无面部麻木组间肿瘤体积差异有统计学意义（t=一2．684，P〈0．05）。按临床分期及T分期分组，组间rr／NT值及肿瘤体积差异均无统计学意义（临床分期H=5．895和1．855，P均〉0．05，T分期日=4．756和0．270，P均〉0．05）。结论18F—FDG符合线路显像诊断鼻咽癌有一定价值，半定量指标T／NT值与肿瘤体积有较好的相关性，T／NT界值的确定需长期大样本研究进一步验证。

Objective To investigate the value of 18F-FDG coincidence imaging for diagnosis of na- sopharyngeal carcinoma. Methods A total of 45 patients with nasopharyngeal carcinoma （33 males and 12 females, average age （55.56 ＋ 13.50） years）, who underwent lSF-FDG coincidence imaging before treat- ment, were studied retrospectively. The images of lSF-FDG coincidence imaging （GE Millennium VG SPECT） and MRI were analyzed. The radioactivity ratio of the accumulated regions to cerebellum （T/NT） was calculated by ROI technique. The volume of nasopharyngeal carcinoma was recorded by MRI. The posi- tive rates of is F-FDG coincidence imaging and EB virus-related antibody measurements were compared by paired X2 test. The correlation between T/NT ratios and tumor volumes were tested by Pearson correlation, and then ROC curves were established. The T/NT ratios and tumor volumes of different groups （different first symptoms, clinical stages, T stages, pathological classification and outcomes, with or without lymph node enlargement） were compared by t-test and rank sum test. Results The positive rate of lSF-FDG coin- cidence imaging was 97.78% （44/45）, and the positive rate of EB virus-related antibody measurement was 95.56% （43/45, X2 = 1.33, P 〉0.05）. The T/NT ratio （2.439 ± 1. 119） and tumor volume （ （7. 311 ± 8. 280 ） cm3 ） of primary lesions had a positive correlation（ r = 0.463, P 〈 0.05 ）. The cut-off values of T/NTratio and the tumor volume were 2. 396 and 7. 348 cm3 , respectively, by ROC curves. T/NT ratios in groups with or without first symptom of epistaxis （2. 847 ＋ 1. 254 vs 2. 082 ＋ O. 863, t = - 2. 409） and groups with or without facial numbness （2. 855 ± 1. 261 vs 2. 134 ±0. 913, t = -2.225） were both signifi- cantly different （ both P 〈 0.05 ）. T/NT ratios of differentiated and undifferentiated cancer were 2. 266 ± 0. 997 and 2. 971 ＋ 1. 351, respectively （ t = - 2. 018, P 〈 0.05 ）. There was a significant difference of tumor volumes between groups with or without facial numbness （ t = - 2.684, P 〈 0.05）. T/NT ratios and tumor volumes between groups of different clinical stages （H = 5. 895 and 1. 855, both P 〉 0.05） and T stages （H = 4. 756 and 0. 270, both P 〉 0.05 ） were significantly different. Conclusions is F-FDG coincidence imaging plays a role in the diagnosis of nasopharyngeal carcinoma. The cut-off value of T/NT ratio is helpful for the prognosis prediction of nasopharyngeal carcinoma.