^18F—FDG PET-CT显像在原发结外淋巴瘤诊断中的应用价值  

The diagnostic value of lSF-FDG PET-CT imaging in patients with primary extranodal lymphoma

作　　者：党娜[1] 徐文贵[1] 宋秀宇[1] 戴东[1] 朱磊[1] 朱湘[1] 马文超[1] 王健[1] 

机构地区：[1]天津医科大学肿瘤医院分子影像及核医学诊疗科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室,300060

出　　处：《中华血液学杂志》2014年第1期35-39,共5页Chinese Journal of Hematology

基　　金：天津市自然科学基金重点项目（08JCZDJC23700）;天津市教委课题（20080133）

摘　　要：目的探讨^18F—FDGPET-CT显像在原发结外淋巴瘤中的诊断价值。方法回顾性分析139例临床疑似原发结外淋巴瘤患者的PET-CT显像结果，以病理学诊断为金标准，比较PET-CT、单纯CT、PET图像在诊断原发性结外淋巴瘤中的敏感性、准确性、特异性及符合率。按病理类型分组，将原发结外淋巴瘤患者最大标准摄取值进行比较，数据进行统计学分析。结果139例患者中经病理证实原发结外淋巴瘤128例，结核、鼻咽癌、胃间质瘤、胃腺癌、肺腺癌、脑胶质瘤、骨髓纤维化、十二指肠腺癌各1例，其他类型转移癌3例。PET-CT诊断出真阳性病例106例，真阴性9例。PET-CT、CT、PET的敏感性分别为82．8％、65．6％、78．9％，特异性分别为81．8％、72．7％、36．4％，准确性分别为82．7％、66．2％、82．0％。PET-CT与CT比较，敏感性、准确性差异有统计学意义（？（2值分别为9．881和10．006，P值分别为0．003和0．002）；与PET比较，特异性差异有统计学意义（X^2=4．487，P=-0．034）。PET-CT与CT比较，胃肠道淋巴瘤、头颈部淋巴瘤、弥漫大B细胞淋巴瘤（DLBCL）诊断符合率差异有统计学意义（Z值分别为5．110、5．278和8．711，P值分别为0．024、0．022和0．003）。PET-CT在不同原发部位、不同病理分型结外淋巴瘤的诊断符合率差异无统计学意义（P〉0．05）。按病理类型分组，黏膜相关淋巴瘤最大标准摄取值为7．4±4．6，与DLBCL（15．8±10．6）和NK／T细胞淋巴瘤（13．6±7．1）比较，差异均有统计学意义（尸值均〈0．05），而DLBCL与NK／T细胞淋巴瘤相比差异无统计学意义（P〉0．05）。结论PET-CT在原发结外淋巴瘤的诊断中具有重要价值，但应注意鉴别诊断，且结果应结合病理诊断。Objective To investigate the diagnostic value of ~SF-FDG PET-CT imaging in primary extranodal lymphoma. Methods A retrospective analysis of 139 clinically suspected primary extranodal lymphoma patients examined by PET-CT and confirmed by biopsies was performed. Considering the pathological diagnosis as the gold standard, PET-CT imaging of all patients was compared with CT and PET to evaluate the efficacy of ^18F-FDG PET-CT in detection of primary extranodal lymphoma. The maximal standardized uptake value （SUVmax） from primary extranodal lymphoma patients was compared, and the data were analyzed by Z2 test. Results Of the total 139 analyzed cases, 128 patients were confirmed to have primary extranodal lymphoma. The sensitivity, specificity and positive rate of PET-CT were 82.8%, 81.8% and 82.7%, respectively, that of CT were 65.6%, 72.7% and 66.2%, and that of PET were 78.9%, 36.4% and 82.0%, respectively. The sensitivity and accuracy of PET-CT were better than that of CT （Z2=9.881, 10.006; P=-0.003, 0.002）. The specificity of PET-CT were better than that of PET （Z2=4.487, P=0.034）. In the gastrointestinal lymphoma, the sensitivity of PET-CT were better than that of CT （X2=5.110, P=0.024）. In the head and neck lymphoma, the sensitivity of PET- CT were better than that of CT （Z2=5.278, P=- 0.022）. In the diffuse large B-cell lymphoma, the sensitivity of PET-CT were better than that of CT （Z2= 8.711, P=0.003 ）. The SUVmax of mucosa-associated lyrnphoma was significantly different from that of diffuse large B-cell lymphoma and natural killer/T-cell lymphoma （7.4±4.6 vs 15.8±10.6, P=0.032; 7.4±4.6 vs 13.6±7.1, P=-0.046）, respectively. Conclusion ^18F-FDG PET-CT imaging is important in the diagnosis of primary extranodal lymphoma, but the differential diagnosis with other disease is important, and the result should be combined with multiple biopsies.

关 键 词：淋巴瘤 正电子发射断层扫描及电脑断层扫描 氟脱氧葡萄糖F18 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学]