基于^(18)F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测

Prediction of tumor histopathological grade using a modified peritoneal cancer index by ^(18)F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei

目的本研究将探讨基于氟-18-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)正电子发射型计算机断层显像/电子计算机断层显像(positron emission tomography/computed tomography,PET/CT)的改良PET-腹膜癌指数(peritoneal cancer index,PCI)、最大标准化摄取值(maximum standardized uptake value,SUV_(max))与最大标准化摄取值/肝脏平均标准化摄取值(SUV_(max)/liver mean standardized uptake value,SUV_(max)/SUV_(mean)_(liver))预测腹膜假黏液瘤(pseudomyxoma peritonei,PMP)组织病理学分级的能力。方法回顾性分析2017年1月至2022年6月间31例阑尾来源PMP患者的临床病理学数据及34例次(3名患者行2次检查)^(18)F-FDG PET/CT检查结果。将13个特定腹盆区域PMP病灶的SUV_(max)评分汇总得到PET-PCI。同时还测量了腹盆腔病灶的SUV_(max)与SUV_(max)/SUV_(mean)_(liver)。结果低级别PMP患者14例、高级别PMP患者12例、高级别伴印戒细胞PMP患者5例。高级别PMP患者的PET-PCI、SUV_(max)和SUV_(max)/SUV_(mean)_(liver)值均高于低级别PMP患者(PET-PCI:23.08±7.47 vs 15.81±10.59,P=0.047;SUV_(max):7.91±4.67 vs 6.73±3.99,P=0.470;SUV_(max)/SUV_(mean)_(liver):3.63±1.89 vs 3.17±2.70,P=0.614)。高级别伴印戒细胞PMP患者的PET-PCI、SUV_(max)及SUV_(max)/SUV_(mean)_(liver)值均高于高级别PMP患者(PET-PCI:25.20±8.84 vs 23.08±7.47,P=0.614;SUV_(max):9.29±8.46 vs 7.91±4.67,P=0.660;SUV_(max)/SUV_(mean)_(liver):3.73±1.83 vs 3.63±1.89,P=0.917)。PET-PCI、SUV_(max)及SUV_(max)/SUV_(mean)_(liver)值的高低与PMP分级一致,但只有高级别PMP患者的PET-PCI与低级别PMP患者之间的差异有统计学意义。结论与SUV_(max)及SUV_(max)/SUV_(mean)_(liver)相比,PET-PCI能更好地反映PMP患者的组织病理学分级。

Objective The aim of this study was to investigate the ability of the modified peritoneal cancer index(PCI)using ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT),maximum standardized uptake value(SUV_(max))and SUV_(max)/liver mean standardized uptake value(SUV_(mean)_(liver))to predict the histopathological grade in patients with pseudomyxoma peritonei(PMP).Methods The pathological data of 31 patients with PMP of appendiceal origin and 34 ^(18)F-FDG PET/CT results(3 patients underwent twice examinations)from January 2017 to June 2022 were analyzed retrospectively.PET-PCI was the sum of the SUV_(max) scores of PMP lesions in 13 specific abdominal-pelvic regions.The SUV_(max) and SUV_(max)/SUV_(mean)_(liver) of the lesion were also measured.Results There were 14 cases of low grade PMP,12 cases of high grade PMP,and 5 cases of high grade with signet ring cells PMP.The PET-PCI,SUV_(max) and SUV_(max)/SUV_(mean)_(liver) values of the high grade were higher than those of the low grade(PET-PCI:23.08±7.47 vs 15.81±10.59,P=0.047;SUV_(max):7.91±4.67 vs 6.73±3.99,P=0.470;SUV_(max)/SUV_(mean)_(liver):3.63±1.89 vs 3.17±2.70,P=0.614).The PET-PCI,SUV_(max) and SUV_(max)/SUV_(mean)_(liver) values of the high grade with signet ring cells were higher than those of the high grade(PET-PCI:25.20±8.84 vs 23.08±7.47,P=0.614;SUV_(max):9.29±8.46 vs 7.91±4.67,P=0.660;SUV_(max)/SUV_(mean)_(liver):3.73±1.83 vs 3.63±1.89,P=0.917);The values of PET-PCI,SUV_(max),and SUV_(max)/SUV_(mean)_(liver) were consistent with the PMP histopathological grade,while there was only a significant different between the PET-PCI of the high-and low-grade PMP.Conclusion Compared with SUV_(max) and SUV_(max)/SUV_(mean)_(liver),PET-PCI can better reflect the histopathological grade of PMP.