18F—FDGPET／CT显像预测肝细胞癌肝移植术后复发价值的初步探讨  

18F-FDG PET/CT in predicting tumor recurrence for hepatocellular carcinoma after liver transplantation

作　　者：许泽清[1] 张祥松[2] 张林启 何巧[2] 张冰[2] 王晓燕[2] 陈志丰[2] 

机构地区：[1]中山大学附属第五医院,珠海519000 [2]中山大学附属第一医院 [3]广州医科大学附属肿瘤医院

出　　处：《中华器官移植杂志》2014年第6期341-345,共5页Chinese Journal of Organ Transplantation

摘　　要：目的初步探讨氟脱氧葡萄糖18F正电子发射断层扫描（18F-FDGPET）／CT显像在预测肝细胞肝癌（HCC）肝移植术后复发的价值。方法回顾性分析52例HCC患者肝移植前的18F-FDGPET／CT检查结果及肝移植后随访结果，根据肝移植受者预后分为复发组和未复发组。根据病灶对FDG的摄取情况，将患者PET／CT检查结果分为PET阳性和阴性；利用PET／CT检查结果计算原发肿瘤最大标准摄取值（Tsuvmax）／正常肝实质本底最大标准摄取值（Bsuvmax），即靶／本值（T／B值），据此将患者分为T／B值≤1．15者和T／B值〉1．15者，均统计患者的肿瘤无复发存活率。结果随访期内，52例中25例（48．1％）复发，27例（51．9％）未复发。复发组的T／B值为2．51±0．95，明显大于未复发组者的1．37±0．46，差异有统计学意义（F4．12，P〈0．001）。PET阴性组和PET阳性组的0．5年、1年、2年和3年肿瘤无复发累积存活率分别为100．0％、92．3%、92．3％和92．3%以及89．7％、59．0%、43．6％和35．7％，PET阴性组高于PET阳性组，差异有统计学意义（X^2=8．78，P=0．003）。T／B值≤1．15组和T／B值〉1．15组的0．5年、1年、2年和3年肿瘤无复发累积存活率分别为100％、92．3％、92．3％和92．3％以及89．5％、59．7oA、42．1％和33．7％，T／B值≤1．15组高于T／B值〉1．15组，差异有统计学意义（X^2=10．24，P=0．001）。结论18F-FDG PET／CT显像对于预测HCC肝移植术后复发具有一定价值。肝移植术前18F-FDGPET／CT显像阴性、T／B值≤1．15的HCC患者，其术后复发的概率相对较低，而18F-FDGPET／CT显像阳性、T／B值〉1．15的HCC患者，其术后复发的概率相对较高。Objective To explore the value of 18F-FDG PET/CT in predicting tumor recurrence for hepatocellular carcinoma （HCC） after liver transplantation （LT）. Method We respectively analyzed 52 patients with HCC who underwent the 18F-FDG PET/CT examination before LT. In terms of tumor recurrence, all patients were divided into recurrence group and non-recurrence group. According to the degree of 18F-FDG uptake, all patients were divided into PET（ - ） group and PET （＋） group. The SUVmax of primary tumor/the SUVmax of normal-liver background （T/B） was calculated by 18F-FDG PET/CT. All patients were then divided into T/B≤0. 15 group and T/B〉1.15 group. Result During the follow-up period,25 out of 52 patients （48. 1%） developed posttransplant HCC recurrence and 27 （51.90%） had no recurrence. T/B of patients with recurrence （2. 51 ± 0. 95） was significantly higher than that of patients with non-recurrence （1.37 ± 0. 46）, t = 4. 12, P〈0. 001. The disease-free survival rate of 0. 5 year,1 year,2 years and 3 years after LT in PET（ - ） group and PET（ ＋ ） group was 100. 0%,92. 3%, 92. 3% and 92. 3%, and 89. 7%, 59. 0%,43. 6% and 35. 7% respectively. Log-rank test revealed that disease-free survival rate in PET（ - ） group was significantly higher than that in PET（ ＋ ） group,X^2 = 17. 8,P = 0. 003. The disease-free survival rate of 0. 5 year, 1 year,2 years and 3 years after LT in T/B≤1. 15 group and T/B〉1. 15 group was 100. 0%,92. 3 %, 92. 3% and 92. 3%,and 89. 5%,59. 7%,42. 1% and 33.7% respectively. Log-rank test showed that disease-free survival rate of T/B≤1. 15 group was significantly higher than that of T/B〉1. 15 group,Z2 = 10. 24, P = 0. 001. Conclusion 18F-FDG PET/CT can predict HCC recurrence after LT. PET（ - ） and T/B≤1.15 of the 18F-FDG PET/CT in patients with HCC after LT were associated with a good prognosis,and PET（ ＋ ） and T/B〉1. 15 of the 18F-FDG PET/CT in patients with HCC after LT with a poor prognosis.

关 键 词：肝细胞癌 肝移植 氟脱氧葡萄糖18F 正电子发射断层显像 体层摄影术 复发 

分 类 号：R735.7[医药卫生—肿瘤]