^(18)F-FDG PET/CT最大标准摄取值与肺癌临床病理特点的关系

Correlation between maximum standardized uptake values of ^(18)F-FDG PET/CT and the clinicopathological characteristics in lung cancer

目的:探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层扫描(PET/CT)最大标准值(SUV_(max))与肺癌TNM分期、病理类型、原发肿瘤体积(primary gross tumor volume,GTV)等临床特征的关系。方法:对116例肺癌患者治疗前行PET/CT检查获得SUV_(max),根据患者不同的临床及病理参数进行分组,采用单因素方差分析(ANOVA)比较不同组间SUV_(max)的差异,SUV_(max)与GTV大小、血红蛋白水平及年龄计量资料的相关性采用Pearson相关分析,与T分期、N分期、TNM分期等级资料的关系采用Spearman秩相关分析。结果:肺鳞癌组、腺癌组、小细胞癌组SUV_(max)分别为19.37±7.88、16.75±9.29和13.71±7.14,小细胞癌组SUV_(max)较鳞癌组低(P=0.008),两者SUV_(max)差异显著,而在其他各组间差异无统计学意义(P>0.05)。肿瘤大小、TNM分期与SUV_(max)之间的单因素相关分析P值分别为0.873、0.046,r分别为0.015、0.186,总体上,肿瘤SUV_(max)与病灶大小无关,但当病灶<45.3cm^3时,肿瘤SUV_(max)与病灶大小中度相关(r=0.456,P=0.013),SUV_(max)与TNM分期之间呈正相关关系。结论:^(18)F-FDG PET/CT SUV_(max)在提示肺癌病理学类型方面有一定帮助,SUV_(max)随肿瘤大小和病期的增加呈升高趋势,可以作为预测肺癌TNM分期的参考指标。

Objective： To investigate the relationship between the maximum standardized uptake value （ SUVmax） detected by 2 - （ 18F） - fluoro - 2 - deoxy - D - glucose - positron emission tomography （ 18F - FDG - PET）/ com-puted tomography （ CT） and clinicopathological characteristics in patients with lung cancer. Methods：18F - FDG PET/CT scanners was performed in 116 pathologically proven lung cancer patients before the treatment. Clinicopatho-logical factors which might affect SUVmax were evaluted,including gender,age,smoking history,WHO performance sta-tus, primary gross tumor volume （GTV） ,histological type,hemoglobin level,tumor locations,TNM stage,T factor,N factor. Results：The SUVmax in squamous carcinoma , adenocarcinoma , small - cell lung cancer were 19. 37 ±7. 88,16. 75 ±9. 29,13. 71 ±7. 14 Respectively. The SUVmax in small - cell lung cancer was smaller than that of squamous carcinoma groups （P = 0. 008） and there were no significant differences between other groups（ P 〉0. 05 ） . The SUVmax was positively correlated with TNM stage（r =0. 186,P =0. 046） . Generally there was no correlation between the GTV and the SUVmal in the 116 patients （r = 0. 015 ,P = 0. 873） ,excepted the group with GTV 〈45. 3cm3 （ r = 0 .4 5 6 ,P =0. 013）. Conclusion ： The SUVmaI of the primary tumor differed significantly between squamous carcinoma and small - cell lung cancer in patients. The SUVmal was positively correlated with TNM stage. When the volume of GTV is 〈45. 3cm3 ,there is correlation between SUVmaI and GTV,and small lesion often has lower SUVmaI.