^(18)F-FDG PET/CT显像评估非小细胞肺癌侵袭性的价值

Value of ^(18)F-FDG PET/CT in evaluating invasiveness of non-small cell lung cancer

目的分析非小细胞肺癌(non-small cell lung cancer,NSCLC)患者^(18)F-FDG PET/CT的影像特征,评价^(18)F-FDG PET/CT对NSCLC侵袭性的预测价值。方法回顾性分析接受^(18)F-FDG PET/CT检查并最终经病理结果证实为NSCLC的初诊患者122例,根据转移情况将患者分为无转移组(n=34)、有转移组(n=88,有淋巴结或者远处转移),测量并分析NSCLC原发灶最大标准化摄取值(SUV_(max)),计算原发灶肿瘤影消失率(TDR),分析原发灶的多种^(18)F-FDG PET/CT影像学特征与发生区域淋巴结转移或远处转移的关系。结果 122例NSCLC病灶中,腺癌88例、鳞癌26例、腺鳞癌6例、类癌2例,无转移组和有转移组患者年龄差异有统计学意义(P<0. 01),且随着原发灶增大、密度增大、TDR减小及SUV_(max)增大,发生区域淋巴结或远处转移的概率均增大(均P<0. 01)。而患者性别、原发灶位置、原发灶病理学分型与是否发生淋巴结或远处转移均无相关性(均P>0. 05)。结论 ^(18)F-FDG PET/CT显像中代谢参数SUV_(max)、TDR等能够更好地对临床NSCLC患者进行危险分层,对评估NSCLC患者预后起到重要指导作用,^(18)F-FDG PET/CT显像对评估NSCLC侵袭性具有重要临床价值。

Objective To assess the value of 18F -FDG PET/CT in evaluating the invasiveness of non-small cell lung cancer(NSCLC). Methods The clinical data of 122 patients with NSCLC receiving 18F -FDG PET/CT examination were retrospectively analyzed.There were 34 patients without metastasis(non-metastasis group) and 88 patients with lymph node or distant metastasis(metastasis group).The maximum standard uptake value(SUV max ) of primary lesion and the tumor disappearance rate(TDR) of the primary lesion were measured.The relationship between 18F -FDG PET/CT features of the primary lesion and lymph node or distant metastasis were analyzed. Results In 122 NSCLC patients,there were 88 cases of adenocarcinoma,26 cases of squamous cell carcinoma,6 cases of adenosquamous cell carcinoma and 2 cases of carcinoid.The age of patients in metastatic group was older than that in metastatic group( P <0.01).The probability of lymph node metastasis or distant metastasis increased with the increase of primary lesion size,density,SUV max value and the decrease of TDR( P <0.01).However,The gender of patients,the location of the primary lesion and the pathological type of the primary lesion were not correlated with lymph node metastasis or distant metastasis( P >0.05). Conclusion The metabolic parameters SUV max and TDR in 18F -FDG PET/CT imaging can better stratify the risk of lymph node and distant metastasis,and are of clinical value in evaluating the invasiveness of NSCLC.