Value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer

BACKGROUND There are limited data on the use of glucose transport protein 1(GLUT-1)expre-ssion as a biomarker for predicting lymph node metastasis in patients with colorectal cancer.GLUT-1 and GLUT-3,hexokinase(HK)-II,and hypoxia-induced factor(HIF)-1 expressions may be useful biomarkers for detecting primary tumors and lymph node metastasis when combined with fluorodeoxyglucose(FDG)uptake on positron emission tomography/computed tomography(PET/CT).AIM To evaluate GLUT-1,GLUT-3,HK-II,and HIF-1 expressions as biomarkers for detecting primary tumors and lymph node metastasis with 18F-FDG-PET/CT.METHODS This retrospective study included 169 patients with colorectal cancer who underwent colectomy and preoperative 18F-FDG-PET/CT at Chungbuk National University Hospital between January 2009 and May 2012.Two tissue cores from the central and peripheral areas of the tumors were obtained and were examined by a dedicated pathologist,and the expressions of GLUT-1,GLUT-3,HK-II,and HIF-1 were determined using immunohisto-chemical staining.We analyzed the correlations among their expressions,various clinicopathological factors,and the maximum standardized uptake value(SUVmax)of PET/CT.RESULTS GLUT-1 was found at the center or periphery of the tumors in 109(64.5%)of the 169 patients.GLUT-1 positivity was significantly correlated with the SUVmax of the primary tumor and lymph nodes,regardless of the biopsy site(tumor center,P<0.001 and P=0.012;tumor periphery,P=0.030 and P=0.010,respectively).GLUT-1 positivity and negativity were associated with higher and lower sensitivities of PET/CT,respectively,for the detection of lymph node metastasis,regardless of the biopsy site.GLUT3,HK-II,and HIF-1 expressions were not significantly correlated with the SUVmax of the primary tumor and lymph nodes.CONCLUSION GLUT-1 expression was significantly correlated with the SUVmax of 18F-FDG-PET/CT for primary tumors and lymph nodes.Clinicians should consider GLUT-1 expression in preoperative endoscopic biopsy in interpreting PET/CT findings.

Correlation of brain cell glucose metabolism and patient's condition in children with epileptic encephalopathy An assessment using fluorine-18-fluoro-2-deoxy-D-glucose positron emission computed tomography

We examined a total of 16 children with epileptic encephalopathy using fluorine-18-fluoro-2-deoxy-D-glucose （18F-FDG） positron emission computed tomography （PET）, magnetic resonance imaging （MRI） and electroencephalography. Children with infantile spasms showed significant mental retardation, severely abnormal electroencephalogram recordings, and bilateral diffuse cerebral cortex hypometabolism with I^F-FDG PET imaging. MRI in these cases showed brain atrophy, multi-micropolygyria, macrogyria, and porencephalia. In cases with Lennox-Gastaut syndrome, 18F-FDG PET showed bilateral diffuse glucose hypometabolism, while MRI showed cortical atrophy, heterotopic gray matter and tuberous sclerosis. MRI in cases with myoclonic encephalopathy demonstrated bilateral frontal and temporal cortical and white matter atrophy and 18F-FDG PET imaging showed bilateral frontal lobe atrophy with reduced bilateral frontal cortex, occipital cortex, temporal cortex and cerebellar glucose uptake. In children who could not be clearly classified, MRI demonstrated cerebral cortical atrophy and ~aF-FDG PET exhibited multifocal glucose hypometabolism. Overall, this study demonstrated that the degree of brain metabolic abnormality was consistent with clinical seizure severity. In addition, ~SF-FDG PET imaging after treatment was consistent with clinical outcomes. These findings indicate that ~SF-FDG PET can be used to assess the severity of brain injury and prognosis in children with epileptic encephalopathy.

^(18)F-fluoro-2-deoxyglucose uptake on PET CT and glucose transporter 1 expression in colorectal adenocarcinoma

AIM:To evaluate the correlation between the level of 18 F-fluoro-2-deoxyglucose (18 F-FDG) uptake and glucose transporter 1 (GLUT1) expression in colorectal adenocarcinoma (CRA).METHODS:Forty four patients with resected CRA and preoperative 18 F-FDG positron emission tomography computed tomography data were investigated in this study.Comparison of maximum standardized uptake value (SUVmax) of the lesion was made with GLUT1 expression by immunohistochemistry and various clinicopathologic factors including tumor volume,invasion depth,gross finding,and lymph node metastasis.RESULTS:SUVmax was 14.45 ± 7.0 in negative GLUT1 expression cases,15.51 ± 5.7 in weak GLUT1 expression cases,and 16.52 ± 6.8 in strong GLUT1 expression cases,and there was no correlation between between GLUT1 expression and SUVmax.SUVmax was significantly correlated with tumor volume (P < 0.001).However,there was no significant differences in SUVmax and GLUT1 expression among other clinicopathologic factors.CONCLUSION:GLUT1 expression does not correlates significantly with 18 F-FDG uptake in CRA.18 F-FDG uptake was increased with tumor volume,which is statistically significant.

Mechanisms underlying ^(18)F-fluorodeoxyglucose accumulation in colorectal cancer

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) is a diagnostic tool to evaluate metabolic activity by measuring accumulation of FDG, an analogue of glucose, and has been widely used for detecting small tumors, monitoring treatment response and predicting patients’ prognosis in a variety of cancers. However, the molecular mechanism of FDG accumulation into tumors remains to be investigated. It is well-known that most cancers are metabolically active with elevated glucose metabolism, a phenomenon known as the Warburg effect. The underlying mechanisms for elevated glucose metabolism in cancer tissues are complex. Recent reports have indicated the potential of FDG-PET/CT scans in predicting mutational status (e.g., KRAS gene mutation) of colorectal cancer (CRC), which suggests that FDG-PET/CT scans may play a key role in determining therapeutic strategies by non-invasively predicting treatment response to anti-epidermal growth factor receptor (EGFR) therapy. In this review, we summarize the current findings investigating the molecular mechanism of 18F-FDG accumulation in CRC.

TyG指数、血清CCL18及骨硬化蛋白对维持性血液透析并发心血管事件的预测价值

目的 探讨甘油三酯葡萄糖(TyG)指数、血清趋化因子配体18(CCL18)及骨硬化蛋白(SOST)对维持性血液透析并发心血管事件的预测价值。方法 选取2019年1月至2021年1月潍坊市人民医院收治的100例维持性血液透析患者,随访2年,根据是否并发心血管事件分为并发心血管事件组(n=30)和未并发心血管事件组(n=70),另选取50名同期来本院体检的健康者作为对照组。对比3组受检者TyG指数、CCL18及SOST表达水平,采用Spearman相关性分析对TyG指数、CCL18及SOST与维持性血液透析并发心血管事件的相关性进行分析。随后进行维持性血液透析并发心血管事件的单因素分析,并将其纳入多因素Logistic回归模型,分析血液透析并发心血管事件的独立影响因素。最后分析TyG指数、CCL18联合SOST检测的预测价值。结果 3组受检者TyG指数、CCL18联合SOST表达水平对比差异显著,并发心血管事件组患者的TyG指数、CCL18及SOST表达水平分别为9.46±2.46、(89.80±13.82) ng/mL、(121.27±13.35) pmol/L,均明显高于未并发心血管事件组[9.46±2.46、(89.80±13.82) ng/mL、(121.27±13.35) pmol/L]和对照组[9.46±2.46、(89.80±13.82) ng/mL、(121.27±13.35) pmol/L],差异均有统计学意义(P<0.05)。Spearman相关分析结果显示:TyG指数、CCL18及SOST与维持性血液透析并发心血管事件呈正相关(P<0.05)。单因素分析结果显示,TyG指数、CCL18、SOST、合并高血脂、合并高血压、合并糖尿病、吸烟史、高磷血症、透析时间是维持性血液透析并发心血管事件的危险因素(P<0.05)。进一步行多因素Logiscic回归分析结果显示,TyG指数、CCL18、SOST、合并高血脂、合并高血压、合并糖尿病、高磷血症是维持性血液透析并发心血管事件的独立危险因素(P<0.05)。TyG指数、CCL18联合SOST预测维持性血液透析并发心血管事件的敏感度和特异度达到94.24%和85.72%,曲线下面积值为0.892。结论 TyG指数、CCL18及SOST水平升高为维持性血液透析并发心血管事件的独立影响因素,且三者联合检测可对维持性血液透析并发心血管事件的发生进行可靠预测。

食管鳞癌患者临床病理特征及^(18)F-FDG PET/CT代谢参数与PD-L1的相关性

目的探讨食管鳞癌(ESCC)患者临床病理特征及^(18)F-氟代脱氧葡萄糖(^(18)F-FDG)正电子发射计算机体层显像仪(PET/CT)代谢参数与程序性死亡受体配体-1(PD-L1)表达的相关性。方法回顾性分析2019年1月至2022年8月期间在揭阳市人民医院经手术治疗的91例ESCC患者临床病理特征及术前^(18)F-FDG PET/CT检查资料。其中,男性66例,女性25例,中位年龄65岁,PD-L1表达阳性45例、阴性46例。分析患者性别、年龄、发病部位、肿瘤分化程度、神经束侵犯、脉管癌栓、T分期、N分期、TNM分期、原发灶最大标准摄取值(SUV_(max))、代谢体积(MTV)、病灶糖酵解总量(TLG)与PD-L1表达水平的相关性。统计学方法采用Mann-Whitney U非参数检验、χ^(2)检验、Spearman相关分析及受试者操作特征曲线(ROC)。结果ESCC T分期、SUV_(max)、TLG均与其PD-L1阳性存在正相关关系,相关系数r分别为0.215、0.297、0.264(均P<0.05)。ROC显示,SUV_(max)、TLG预测PD-L1阳性的曲线下面积(AUC)为0.671、0.623。结论ESCC T分期及SUVmax、TLG与PD-L1表达水平存在相关性,可在一定程度上反映肿瘤的PD-L1表达情况。

Functional imaging of skeletal muscle glucose metabolism by ¹⁸FDG PET to characterize insulin resistance in patients at high risk for coronary artery disease

Insulin resistance is associated with several coronary risk factors and is thought to play a critical role for the development of coronary artery disease. Insulin resistance has several causes, including an impaired skeletal muscle glucose utilization rate (SMGU), reduced peripheral blood flow, and altered fatty tissue metabolism, with SMGU being considered the most important. Nonetheless, insulin resistance has only been estimated by the glucose disposal rate (GDR) in previous studies. Methods: Skeletal muscle metabolic imaging with 18FDG and positron emission tomography (PET) was undertaken to measure SMGU during hyperinsulinemiceuglycemic clamping in 22 normotensive type-2 diabetics under no medications (T2- DM), 17 normotensive non-diabetic hypertriglyceridemics, 22 patients with hypertension, and 12 agematched controls. Whole body insulin resistance was assessed by the GDR during hyperinsulinemiceuglycemic insulin clamping. Results: The SMGU and GDR were significantly reduced in T2DM (32.1 ± 16.6 μmol/min/kg and 24.3 ± 13.0 μmol/min/kg, respectively), hypertriglyceridemics (36.5 ± 13.5 μmol/min/ kg and 22.7 ± 8.07 μmol/min/kg respectively) and patients with hypertension (35.4 ± 26.6 μmol/min/kg and 29.0 ± 9.90 μmol/min/kg, respectively) compared with controls (72.2 ± 44.1 μmol/min/kg and 43.0 ± 22.9 μmol/min/kg, p < 0.01, respectively). In all groups studied, SMGU was significantly correlated with GDR (r = 0.76, p < 0.01) and GDR (F = 13.9) was independently related to SMGU (r = 0.81, p < 0.01). Conclusion: Insulin resistance is significantly associated with SMGU to a similar degree among patients with T2DM, essential hypertension and hypertriglyceridemia. 18FDG PET functional imaging allows insulin resistance to be assessed.

Low glucose metabolism in hepatocellular carcinoma with GPC3 expression

AIM To investigate the relationship between glucose metabolism and glypican-3(GPc3)expression in hepatocellular carcinoma(Hcc).METHODSImmunohistochemical staining of pathological samples for GPc3 and glucose transporter 1(GLUT1),and whole-body ^(18)F-FDG PET/c T for measuring tumour glucose uptake were performed in 55 newly diagnosed Hcc patients.The maximum standard uptake value(s UVmax)and tumour-to-non-tumourous liver uptake(T/NT)ratio were used to quantify ^(18)F-FDG uptake.In vitro ^(18)F-FDG uptake assay of GPc3-expressing Hep G2 and non-GPc3-expressing RH7777 cel ls was used to examine the effect of GPc3 in cellular glucose metabolism.The relationships between GPc3 expression and ^(18)F-FDG uptake,GLUT1 expression,tumour differentiation,and other clinical indicators were analysed using spearman rank correlation,univariateand multiple logistic regression analyses.RESULTSPositive GPc3 expression was observed in 67.3%of Hcc patients,including 75.0%of those with well or moderately differentiated Hcc and 36.4%of those with poorly differentiated Hcc.There was an inverse relationship between GPc3 expression and s UVmax(Spearman correlation coefficient=-0.281,P=0.038)and a positive relationship between GLUT1 expression and sU Vmax(Spearman correlation coefficient=0.681,P<0.001)in patients with Hcc.Univariate analysis showed that two glucose metabolic parameters(sU Vmax and T/NT ratio),tumour differentiation,lymph node metastasis,and TNM stage were all significantly associated with GPc3 expression(P<0.05),whereas GLUT1 expression,sex,age,tumour size,intrahepatic lesion number,and distant metastasis showed no statistical association(P>0.05).Further multivariate analysis revealed that only the T/N ratio was significantly correlated with GPC3 expression in patients with Hcc(P<0.05).In vitro assay revealed that the uptake of ^(18)F-FDG in GPc3-expressing HepG2 cells was significantly lower than that of non-GPc3-expressing RH7777 cells(t=-20.352,P<0.001).CONCLUSIONThe present study demonstrated that GPc3 expression is inversely associated with glucose metabolism,suggesting that GPc3 may play a role in regulating glucose metabolism in Hcc.

Glucose Metabolic Alteration of Cerebral Cortical Subareas in Rats with Renal Ischemia/Reperfusion Based on Small-Animal Positron Emission Tomography

Objective:To investigate glucose metabolic alterations in cerebral cortical subareas using ^(18)F-labeled glucose derivative fluorodeoxyglucose(FDG)micro-positron emission tomography(PET)scanning in a rat renal ischemia/reperfusion(RIR)model.Methods:Small-animal PET imaging in vivo was performed with ^(18)F-labeled FDG as a PET tracer to identify glucose metabolic alterations in cerebral cortical subregions using a rat model of RIR.Results:We found that the average standardized uptake value(SUV_(average))of the cerebral cortical subareas in the RIR group was significantly increased compared to the sham group(P<0.05).We also found that glucose uptake in different cortical subregions including the left auditory cortex,right medial prefrontal cortex,right para cortex,left retrosplenial cortex,right retrosplenial cortex,and right visual cortex was significantly increased in the RIR group(P<0.05),but there was no significant difference in the SUV_(avcrage) of right auditory cortex,left medial prefrontal cortex,left para cortex,and left visual cortex between the two groups.Conclusion:The ^(18)F-FDG PET data suggests that RIR causes a profound shift in the metabolic machinery of cerebral cortex subregions.

Measurement of lumbar muscle glucose utilization rate can be as useful in estimating skeletal muscle insulin resistance as that of thigh muscle

Background: Skeletal muscle glucose utilization (SMGU) can be accessed by positron emission tomography (PET) and18F-FDG to characterize insulin resistance. The quantity of skeletal muscle in the lumbar is sufficient to indicate that SMGU in the lumbar (SMGU- lumbar) can be measured with18F-FDG PET of the chest instead of obtaining thigh muscle SMGU (SMGU-thigh). This would reduce PET scan time to avoid thigh muscle PET scan. This study was aimed to compare SMGU-lumbar and thigh muscle SMGU under insulin clamping to identify the validity of measurements of SMGU in the lumbar for studies of insulin resistance. Methods: Thirty-three patients underwent sequential dynamic18F-FDG PET of both the thoracic (37 min) and thigh region (22 min) during hyperinsulinemic euglycemic insulin clamping. Both SMGU-lumbar and SMGU-thigh were calculated by Patlak graphical analysis. Whole body insulin resistance was assessed by a whole body glucose disposal rate during hyperinsulinemic euglycemic insulin clamping. Input function was obtained from the time activity curve of the descending aorta and venous blood sampling as previously validated. Results: SMGU-thigh (0.0506 ± 0.0334 μmol/min/g) was comparable to SMGU-lumbar (0.0497 ± 0.0255 μmol/min/g). The Bland-Altman method of difference plot analysis showed a significant correlationship between SMGU- thigh and SMGU-lumbar (r = 0.506, p = 0.0028). There were seen very good significant correlationship between whole body glucose utilization rate in both thigh (r = 0.737, p = 0.0001) and lumbar (r = 0.772, p = 0.0001). Conclusion: These results support the validity of measuring SMGU-lumbar to estimate insulin resistance during PET imaging of the chest.

Using fluorodeoxy-D-glucose-positron emission tomography to monitor neoadjuvant chemotherapy response in sarcoma:A meta-analysis

AIM： To systematically evaluate the accuracy of 18-fu-orodeoxy-D-glucose-positron emission tomography （18-FDG PET） to assess response to neoadjuvant che-motherapy in bone and soft tissue sarcomas.METHODS： Studies published in English language re-garding the accuracy of F-18 FDG PET for the indication were retrieved from MEDLINE. The QUADAS tool was utilized for methodological quality appraisal. Relevant data were extracted, and quantitative data synthesis included pooled estimation and subgroup analysis. RESULTS： A total of ffteen studies involving 420 pa-tients with pathologically confrmed sarcoma were col-lected. Methodological quality was relatively high. The pooled sensitivity and specifcity of PET to predict histo-pathological response were 87% （95%CI： 81%-91%） and 83% （95%CI： 77%-87%）, respectively. Ten stud-ies employed a lower standardized uptake value （SUV） after chemotherapies （mostly 2.5） and/or a higher SUV reduction rate （mostly around 50%） as PET criteria of good response. Subgroup analysis showed that PET ex-hibited a signifcantly better specifcity in osteosarcoma （OS） and Ewing sarcoma （ES） than in soft-tissue sarco-ma （STS） （91% vs 75%, P 〈 0.05）, and a higher speci-fcity in pediatric patients than in adults （90% vs 74%, P 〈 0.01）. PET yielded a lower specifcity in ifosfamide-contained chemotherapies than in the alternative regi-men （70% vs 97%, P 〈 0.01）.CONCLUSION： F-18 FDG PET is promising to predict neoadjuvant therapy response in sarcoma, especially in pediatric patients with OS or ES. Certain chemothera-peutic agents could potentially cause false positives of PET.

血糖浓度对荷瘤小鼠^(18)F-FDG体内分布的影响

为探讨血糖浓度对荷瘤小鼠18F-FDG体内分布的影响,取35只皮下接种艾氏腹水癌(EAC)一周后的小鼠禁食20h,随机分为对照组(n=11)与糖负荷组(n=12),分别给予蒸馏水和50%葡萄糖0.5mL灌胃,另有两组分别给予10%葡萄糖(5只)和30%葡萄糖(7只)0.5mL灌胃,1h后测血糖并尾静脉注射18F-FDG,再1h后放血处死,计算各组织SUV及肿瘤SUVc。糖负荷组荷瘤小鼠血糖浓度(11.98±3.01mmol/L)较对照组(3.95±1.11mmol/L)显著升高(P<0.01);糖负荷组小鼠的肿瘤、脑、脾、血SUV及肿瘤与肌肉摄取比(1.34,0.86,0.48,0.09,1.38)显著低于对照组(3.02,2.62,0.80,0.16,5.38)(P<0.01),心、肌肉SUV及肿瘤与脑、心与血摄取比(8.31,1.05,1.58,103.00)显著高于对照组(1.57,0.64,1.20,9.73)(P<0.01);肺、肝、肾SUV及肿瘤SUVc在两组间无显著差异(P>0.05)。肿瘤、脑、脾、血SUV及肿瘤与肌肉摄取比与血糖浓度呈显著性负相关,r分别为:-0.76,-0.92,-0.78,-0.48,-0.63(P<0.01);心、肌肉SUV及肿瘤与脑、心与血摄取比、肿瘤SUVc与血糖浓度呈显著性正相关,r分别为:0.85,0.43,0.51,0.85,0.45(P<0.01)。结果表明,血糖浓度变化显著影响荷瘤小鼠肿瘤及正常组织对18F-FDG的摄取。

血糖水平对原发性肝癌患者^(18)F-FDG摄取和PET/CT检查图像质量的影响研究

目的探讨原发性肝癌(PLC)患者血糖水平对肝脏氟脱氧葡萄糖F^(18)(^(18)F-FDG)摄取的影响。方法 2015年1月～2018年1月我院行正电子发射断层显像/电子计算机断层扫描(PET/CT)检查的PLC患者187例,其中空腹血糖水平正常者71例,高血糖者116例。在PET/CT检查后,测量肝右叶平均标准化摄取值(SUVmean)。比较两组肝图像质量和^(18)F-FDG摄取结果,采用相关分析和偏相关分析计算连续性变量与肝脏SUVmean间的相关系数和偏相关系数,再行多元逐步线性回归分析影响肝脏SUVmean的影响因素。结果血糖正常患者肝图像质量为0级者5例(7.0%),1级者14例(19.7%),显著低于血糖升高患者的20例(17.2%)和31例(26.7%),肝图像质量为2级者21例(29.5%),为3级者31例(43.8%),显著高于血糖升高患者的30例(25.8%)和35例(30.3%,P<0.05);高血糖组患者肝脏^(18)F-FDG摄取为(5.1±1.4),显著高于血糖水平正常组患者【(3.9±1.3),P<0.05】;血糖、年龄、FT3和基础代谢率(BMR)与SUVmean间的相关和偏相关系数均存在统计学意义(P<0.05),多元回归分析显示,血糖、年龄和血清甲状腺素(FT3)是影响肝脏SUVmean变化的独立因素。结论血糖水平可影响PLC患者肝脏^(18)F-FDG摄取和PET/CT检查图像质量,而年龄和血清FT3也是影响肝脏SUVmean变化的独立因素。临床在行^(18)F-FDG PET/CT检查前,应积极调控血糖水平至合理范围,并在判读PET/CT检查图像时,考虑到这些因素的影响。

^(18)F-FDG PET/CT在远隔缺血后适应对急性ST段抬高型心肌梗死患者再灌注损伤影响中的应用

目的探讨氟-18标记的脱氧葡萄糖(18 F-FDG)放射性核素行正电子发射断层代谢显像(PET/CT)在远隔缺血后适应对急性ST段抬高型心肌梗死患者再灌注损伤治疗策略和疗效评估中的作用。方法回顾性分析307例急性ST段抬高型心肌梗死患者的临床资料,选择其中治疗后成功在核医学科行PET/CT检查的51例患者进入本研究,根据手术方法分为A组[冠脉血运重建术(PCI)]和B组[冠脉血运重建术+远隔缺血后适应(PCI+RIPostC)],通过半定量评分的方法确定心室各节段葡萄糖代谢和心肌运动情况。结果 2组患者心肌的17个阶段中,第1、2、3、4、6、7、8、9、10段比较,差异无统计学意义(P>0.05)。第5、11、12、13、14、15、16、17段与A组比较,B组心肌存活的数量明显增多,差异具有统计学意义(P <0.05)。2组患者PET/CT测算的左室射血分数(LVEF)值比较,B组左室心功能较A组改善明显,差异具有统计学意义(P=0.017)。结论 RIPerC可改善ST段抬高型心肌梗死(STEMI)患者术后左心功能,通过心脏18 F-FDG PET/CT评估,RIPerC显著增加梗死区心肌细胞存活数量,在其治疗策略和疗效评估中有较高的应用价值。

细支气管肺泡癌葡萄糖易化扩散转运蛋白-1表达特点及与^(18)F-脱氧葡萄糖摄取的关系

目的探讨葡萄糖易化扩散转运蛋白-1(Glut1)在细支气管肺泡癌(BAC)组织中表达的特点及与18F-脱氧葡萄糖(18F-FDG)摄取之间的关系。方法20例BAC患者术前行18F-FDG正电子发射体层显像(PET)检查,检测肿瘤最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)及正常肺组织标准摄取值(SUVlung)。采用标准链霉菌抗生物素蛋白-过氧化物酶亲和(SP)免疫组织化学染色法对肿瘤与周围正常支气管肺组织的Glut1表达情况进行检测,观察其染色阳性细胞率与染色强度。结果20例患者肿瘤的18F-FDG摄取高于相应的正常肺组织(SUVmax、SUVmean和SUVlung分别为3.09±1.35,2.37±1.03和0.39±0.09)。20例BAC组织均有Glut1的表达(阳性细胞率73.8%±14.8%,染色强度2.8±0.9级),但肿瘤组织普遍表现为胞浆着色,染色强度较弱。正常支气管肺组织无Glut1表达1。8F-FDG摄取和Glut1表达与肿瘤大小呈正相关(P<0.01)。结论BAC组织中Glut1表达有其自身的特点,与18F-FDG摄取有关。

18F-FDG PET/CT对非小细胞肺癌淋巴结转移的诊断价值

目的探讨18氟-脱氧葡萄糖正电子发射计算机断层显像/计算机体层成像(18F-FDG PET/CT)对非小细胞肺癌淋巴结转移的诊断价值。方法回顾性分析2012年3月至2015年3月我院167例患者的临床资料,所有病例术前10 d内行18FFDG PET/CT及胸部增强CT检查并经术后病理诊断为非小细胞肺癌。根据PET/CT、增强CT及术后病理结果,计算PET/CT、增强CT判断淋巴结转移的灵敏度、特异性、准确度、阳性预测值、阴性预测值及约登指数并相互比较。结果 167例患者中共清扫出731组淋巴结,以术后病理结果为依据,PET/CT诊断出真阳性、假阳性、假阴性、真阴性淋巴结各有143组、26组、61组、501组,进而得出其灵敏度、特异度、准确度、阳性预测值、阴性预测值、约登指数分别为70.10%、95.07%、88.10%、84.62%、89.15%、0.65,增强CT分别为54.19%、92.23%、81.67%、72.85%、83.97%、0.4,二者差异有统计学意义(P<0.05)。结论 PET/CT对非小细胞肺癌淋巴结转移的诊断效能高于增强CT,可以更好地为肺癌术前诊断、分期和后续治疗方式的选择提供依据。

^(18)F-FDG PET/CT在肝癌患者接受肝脏器官移植术前、后的临床应用价值(英文)

目的评价18F-FDG PET-CT 在肝癌患者肝移植术前评估和在术后早期发现小复发病灶中的价值。方法回顾性分析 19 例肝癌患者拟行或已行肝移植手术患者的临床和 18F-FDG PET-CT 影像学资料。肝移植术前进行 18F-FDGPET-CT 扫描 8 例 10 次, 肝移植术后进行 18F-FDG PET-CT 扫描者 22 次(11 例患者)。结果 8 例肝移植术前评估的患者中有 2 例 PET 显像全身各部位均未发现转移性病灶, 均按期接受了肝移植手术; 有 2 例 PET 显示转移灶位于拟手术野区域内, 故也按期进行了移植手术( 术中对局部的转移灶做了外科清扫) ; 有 4 例患者因已有不同程度的远处转移, 与家属讲明原因后放弃肝移植手术, 而改用介入或其他内科治疗。肝移植术后进行扫描者 22 次(11 例患者) , 其中 2 例患者术后行 PET 检查未发现肿瘤复发及全身其他部位的转移灶; 1 例患者术后发现霉菌性脑脓肿; 在其余 19 次(8 例患者)PET 检查中发现移植的肝内出现复发病灶者 4 例, 另外还发现肝左右静脉和下腔静脉内癌栓、肺内、多部位多发淋巴结、骨、脾脏内、胸壁胸膜、胸椎椎间孔等处转移征象。结论 18F-FDG PET- CT 全身性扫描兼有对肿瘤显示高度敏感性的两个优势, 在肝移植术前评估和术后早期发现复发病灶的临床应用中均起着重要和不可替代的作用。

^(18)F-氟代脱氧葡萄糖PET/CT显像评价弥漫大B细胞淋巴瘤化疗早期对化疗药物敏感性的价值

目的:探讨^(18)-氟代脱氧葡萄糖(^(18)-FDG)PET/CT显像评价弥漫大B细胞淋巴瘤(DLBCL)化疗早期对化疗药物敏感性的价值。方法:32例病理确诊为DLBCL的患者,采用环磷酰胺+阿霉素+长春新碱+泼尼松(CHOP方案)或利妥昔单抗注射液+CHOP方案(R-CHOP方案),分别于化疗前和第二疗程化疗后2周(早期)做18 F-FDG PET/CT全身显像,根据DLBCL对化疗药物敏感性的程度分为3组:肿瘤活性完全灭活组,肿瘤活性部分灭活组和疗效不明显组,比较3组患者治疗前及第二疗程化疗后病灶摄取18 F-FDG标准摄取值最大值(SUVmax)的大小及缓解率。结果:(1)肿瘤活性完全灭活组治疗前:SUVmax(17.71±8.95),第二疗程化疗后肿瘤活性完全灭活。(2)肿瘤活性部分灭活组治疗前:SUVmax(18.96±8.13),治疗后:SUVmax(10.27±8.63),治疗前后比较差异有统计学意义(t=3.24,P=0.014)。(3)疗效不明显组治疗前SUVmax(10.8±5.8),治疗后SUVmax(11.5±6.7),治疗前后比较差异无统计学意义(t=-1.0,P=0.5)。肿瘤活性完全灭活组和肿瘤活性部分灭活组临床缓解率分别为68.7%(22/32),25.0%(8/32)(P<0.05)。结论:18 F-FDG PET/CT显像评价DLBCL化疗早期对化疗药物敏感性有较高的临床价值。

^(18)F-FDGPET/CT在弥漫大B细胞淋巴瘤临床分期及评价化疗反应中的价值

目的:探讨18F-FDG PET/CT对弥漫大B细胞淋巴瘤(diffuse B-cell large lymphoma,DLBCL)临床分期及评价化疗中期治疗反应的价值。方法:29例初诊的DLBCL化疗前和化疗中期均行18F-FDG PET/CT检查,根据肿瘤对化疗的反应将病例分为无反应组、部分反应组及完全反应组,采用χ2检验和Fisher确切概率法比较3组患者的完全缓解率。结果:18F-FDG PET/CT改变了10.3%(3/29)患者的临床分期。无反应组、部分反应组及完全反应组的临床完全缓解率分别为16.7%(1/6)、69.2%(9/13)和80.0%(8/10),3组间差异有统计学意义(χ2=7.033,P=0.030)。完全反应组、部分反应组的完全缓解率明显高于无反应组(χ2=4.310,P=0.038;χ2=5.730,P=0.017)。结论:18F-FDG PET/CT显像有助于临床分期;化疗中期18F-FDG PET/CT显像有助于预测化疗疗效。

肝脏^(18)F-FDG PET半定量方法比较分析

目的比较肝脏^(18)氟脱氧葡萄糖正电子发射体层摄影/计算机体层摄影[2-(fluorine-18)-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography,^(18)F-FDG PET/CT]半定量方法及其受血糖、血脂、肝酶、体质指数(body mass index,BMI)、年龄及性别等因素的影响。方法回顾性分析678例健康人群PET/CT、常见血液化验结果及基本信息等资料,测量肝脏平均标准化摄取值(standardized uptake value,SUV)和基于瘦质体重(lean body mass,LBM)与体表面积(body surface area,BSA)校正的SUV_(LBM)和SUV_(BSA)。比较三者的变异系数大小,并采用相关、偏相关和多元线性回归分析比较三者受血液化验指标的影响程度。结果SUV、SUV_(LBM)和SUV_(BSA)的变异系数(23.3%、23.4%和24.7%)相当。SUV受年龄、BMI、高密度脂蛋白(high density lipoprotein,HDL)和三酰甘油(triglyceride,TG)的影响(P值均<0.05),SUVBSA受性别、年龄、BMI和HDL的影响(P值均<0.05),而SUV_(LBM)仅与性别和年龄有关(β=0.092和0.004,P=0.002和0.007),不受常见血液化验指标的影响。结论肝脏SUV和SUV_(BSA)均受常见血液指标的影响,而SUVLBM不受血液化验指标的影响,有望用于18F-FDG PET半定量评估。