18F-FDG PET-CT显像在甲状腺肿瘤中的应用及与临床病理的相关性分析

Application of 18F-FDG PET-CT Imaging in Thyroid Tumour and Its Correlation with Clinical Pathology

目的探讨18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层扫描(PET-CT)糖代谢参数和甲状腺癌临床病理的关系。方法收集2015年1月~2018年12月在我院行18F-FDG PET-CT显像检查并经手术病理证实的甲状腺癌患者49例,分别对甲状腺癌灶和正常组织的最大标准摄取值(SUVmax)进行测量,分析不同病理类型及有无淋巴结转移的甲状腺癌灶的SUVmax的差异。结果49例患者,18F-FDG PET-CT显像共检出癌灶49个。病理检查发现癌灶57个,分化型甲状腺癌38例,非分化型甲状腺癌11例;淋巴结转移22例,无淋巴结转移27例。甲状腺癌灶SUVmax为(5.39±1.42),明显高于正常甲状腺组织(1.62±0.39)(P<0.05)。分化型甲状腺与非分化型甲状腺癌的SUVmax对比无统计学差异(P>0.05),有淋巴结转移与无淋巴结转移的甲状腺癌灶SUVmax对比亦无统计学差异(P>0.05)。Pearson相关性分析显示,甲状腺癌灶SUVmax与病灶大小呈正相关(r=0.412,P<0.05)。结论18F-FDG PET-CT显示糖代谢增高对甲状腺癌有高度提示价值,但糖代谢水平与肿瘤病理类型及肿瘤分期可能无明显相关性。

Objective To investigate the relationship between glucose metabolism parameters and clinical pathology of thyroid cancer detected by 18F-fluorodeoxy glucose(18F-FDG)positron emission tomography-computed tomography(PET-CT).Methods A total of 49 patients confirmed with thyroid cancer by surgical pathology who underwent 18F-FDG PET-CT imaging in the hospital from January 2015 to December 2018 were enrolled.The maximum standardized uptake values(SUVmax)of thyroid cancer lesions and normal tissues were measured.The differences of different pathological types and SUVmax of thyroid cancer lesions with or without lymph node metastasis were analyzed.Results In the 49 patients,there were 49 detected by 18F-FDG PET-CT imaging.There were 57 cancer lesions detected by pathological examination,38 cases with differentiated thyroid cancer,11 cases without non-differentiated thyroid cancer,22 cases with lymph node metastases and 27 cases without lymph node metastases.The SUVmax of thyroid cancer was significantly higher than that of normal thyroid tissue[(5.39±1.42)vs(1.62±0.39)](P<0.05).There was no significant difference in SUVmax between differentiated thyroid and non-differentiated thyroid cancer(P>0.05).There was no significant difference in SUVmax of thyroid cancer with lymph node metastasis and without lymph node metastasis(P>0.05).Pearson correlation analysis showed that SUVmax of thyroid cancer lesions was positively correlated with lesions size(r=0.412,P<0.05).Conclusion 18F-FDG PET-CT shows that increase of glucose metabolism has high prompting value for thyroid cancer.But there may be no significant correlation between glucose metabolism level and tumor pathological type or tumor stage.