原发性肺癌原发灶PET/CT征象与发生淋巴结及远处转移的相关性研究

Correlation between the PET/CT signs of primary lung cancer and metastases

目的探讨原发性肺癌原发灶PET/CT征象与其发生转移的相关性。方法回顾性分析166例经病理证实为原发性肺癌治疗前PET/CT表现。按照有无转移分为转移组和无转移组,分析两组间患者标准放射性摄取最大值（standardized uptake value,SUVmax）、病灶与周围胸膜相关表现及淋巴转移和远处转移的关系。按照原发灶与胸膜的关系分为密切组和非密切组,分析两组间CT征象与病灶转移之间的关系;观察其原发灶CT征象及PET表现与发生转移之间的关系;并对166例进行Logistic多因素回归分析。结果转移组的SUVmax为（12.19±5.46）,无转移组的SUVmax为（8.03±4.72）,两组间差异具有统计学意义（P〈0.05）。密切组伴淋巴转移42例,非密切组伴淋巴转移75例;CT表现分叶征者有86例;短毛刺征仅45例;病灶SUVmax为（1.1-31.1）,其中SUVmax延迟上升102例,延迟下降6例;无病灶转移12例,有淋巴结转移86例,骨转移56例,实质脏器转移36例。结论病灶SUVmax值及病灶周围胸膜表现可以预测远处转移。毛刺征与有无转移无明显相关;分叶征病灶与转移有相关（r=0.319）,但无特异性。SUV值增加以及伴远处转移均为预测淋巴转移的独立因子,其他变量指标不能作为独立预测因子;淋巴转移亦为预测远处转移的独立因子。

Objective To investigate the correlation between the PET/CT signs of primary lung cancer and metastases.Methods 166 patients with primary lung cancer were included in this study.The pre-treatment PET / CT signs were retrospectively analyzed.The patients were divided into metastasis group and no-metastasis group.The relationship of the SUVmax and the metastasis,lymphnode metastasis and distant metastasis between the two groups was analyzde.The petients were divided into relation and no-relation group according to the relationship between primary focal and pleural,and the relationship between the pleural performance primary and the metastasis was analyzed.To observe the relationship between metastasis and CT,PET / CT signs of primary,166 patients were analyzed with Logistic multi-factor regression.Results The average of SUVmax was（12.19 ± 5.46） and（8.03 ± 4.72） in the metastasis group and no-metastasis group,which was statistically significant difference between the two groups（P〈0.05）.75 patients with lymphnode metastasis in the relation group,42 patients with lymphnode metastasis in the no-relation group,86 patients with lobulation,only 42 patients with short sentus.The SUVmax was 1.1-31.1,102 patients with delayed rise,6 cases with decline.12 cases of no metastasis,86 cases of lymph node metastasis,56 cases of bone metastases,36 cases of solid organ metastasis.Conclusion The SUVmax and pleura manifestation can predict the distant metastasis.Sentus has no obvious correlation with metastasis.Lobulation has correlation with metastasis（r = 0.319）,but no specificity.SUV level increases and pleura manifestation were independent prediction factors for lymph node metastases,the others were not as an independent prediction factor.The lymph node metastases were independent factor for predicting distant metastasis.