肺大细胞神经内分泌癌^18F-FDG PET-CT显像最大标准摄取值与临床病理特征的关系

Relationship between maximum standardized uptake value of 18F-FDG PET-CT and clinicopathological features in pulmonary large cell neuroendocrine carcinoma

目的探讨肺大细胞神经内分泌癌(LCNEC)的18F-FDGPET-CT显像中原发肿瘤最大标准摄取值(SUVmax)与临床病理特征的关系。方法回顾性分析南京医科大学第一附属医院2009年10月至2017年5月接受18F-FDGPET-CT检查并经手术病理证实的43例肺LCNEC患者的临床病理资料。对可能影响原发肿瘤SUVmax的因素,包括患者年龄、性别、肿瘤部位、肿瘤类型、肿瘤最大径、T分期、N分期、M分期、TNM分期进行单因素及多因素分析。结果43例肺LCNEC患者原发肿瘤SUVmax为11.9±4.9,肿瘤最大径为(3.2±1.4)cm,二者呈正相关(r=0.533,P=0.000)。单因素分析结果显示:原发肿瘤的SUVmax与肿瘤最大径、T分期、N分期、M分期及TNM分期有关(均P<0.05),而与患者年龄、性别、肿瘤位置、肿瘤类型无关(均P >0.05)。logistic多因素分析结果显示:肿瘤最大径、N分期、M分期、TNM分期是SUVmax的独立影响因素(OR=2.087、2.852、2.315、-2.200,均P<0.05)。原发肿瘤SUVmax对淋巴结转移具有一定的预测价值,当界值点为13.5时诊断效率最高,灵敏度为64.7%,特异度为92.3%。结论肺LCNEC原发肿瘤18F-FDGPET-CT显像中SUVmax与肿瘤最大径、N分期、M分期及TNM分期密切相关,原发肿瘤SUVmax对判断淋巴结转移具有一定的参考价值。

Objective To investigate the correlation of clinicopathological features and maximum standardized uptake value (SUVmax) detected by 18F-FDG PET-CT in pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The clinicopathological data of 43 pulmonary LCNEC patients who underwent 18F-FDG PET-CT and were confirmed by pathology in the First Affiliated Hospital with Nanjing Medical University From October 2009 to May 2017 were retrospectively analyzed. Univariate and multivariate analyses were performed on factors that may affected SUVmax in the primary tumor, including the patient's age, gender, tumor location, tumor type, tumor maximum diameter, T stage, N stage, M stage, and TNM stage. Results The SUVmax and tumor maximum diameter of 43 pulmonary LCNEC patients were 11.9±4.9 and (3.2±1.4) cm, and there was a positive relation between SUVmax and tumor maximum diameter (r = 0.533, P = 0.000). The univariate analysis showed that SUVmax was correlated with tumor maximum diameter, T stage, N stage, M stage and TNM stage (all P < 0.05), but was not correlated with patient's age, gender, tumor location, and tumor type (all P > 0.05). The multivariate analysis showed that tumor location, N stage, M stage and TNM stage were the independent influencing factors of SUVmax (OR = 2.087, 2.852, 2.315, -2.200, all P < 0.05). Primary tumor SUVmax had predictive value for lymph node metastasis, when the cut-off value was 13.5, the diagnostic efficiency was the highest, the sensitivity was 64.7%, and the specificity was 92.3%. Conclusions The SUVmax detected by 18F-FDG PET-CT in pulmonary LCNEC is correlated with tumor maximum diameter, N stage, M stage and TNM stage. Primary tumor SUVmax has a certain reference value for predicting lymph node metastasis.