^18氟-氟代脱氧葡萄糖 PET／CT 显像对评价肝癌肝移植患者预后的价值  

Feasibility study of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography in proposing selection criteria for patients with hepatocellular carcinoma in liver transplantation

作　　者：许泽清[1] 张林启 王晓燕[1] 张祥松[1] 

机构地区：[1]中山大学附属第一医院核医学科,,广州510080

出　　处：《中华医学杂志》2014年第31期2422-2425,共4页National Medical Journal of China

摘　　要：目的：初步探讨18氟-氟代脱氧葡萄糖（18 F-FDG） PET/CT显像作为肝癌肝移植筛选标准的可行性。方法回顾性分析2008年9月至2012年3月中山大学附属第一医院肝移植科初治的31例肝移植术前未经抗肿瘤治疗的肝细胞癌（ HCC ）患者；术前行18 F-FDG PET/CT，将肿瘤的Tsuvmax/Bsuvmax值（简称T/B值）作为反映代谢活性的半定量指标，应用ROC曲线计算T/B影响HCC肝移植后复发转移的最佳临界值。通过单因素和多因素分析方法对31例患者临床病理特征进行分析，明确影响HCC肝移植术后复发的危险因素。结果随访期间肿瘤转移复发的总发生率为51.6％（16/31），移植后6个月、1年、2年无瘤生存率分别为93.5％、67.7％、46.8％。单因素分析结果显示，影响HCC肝移植患者术后肿瘤复发转移的变量有T/B值、肿瘤最大径、肿瘤数目、术前AFP水平。 Cox回归多因素分析结果显示，T/B值、AFP水平和肿瘤数目是影响HCC肝移植后复发的独立因素。结论 T/B值、术前AFP水平和肿瘤数目是影响HCC肝移植术后复发的独立危险因素；18 F-FDG PET/CT作为肿瘤生物学行为的预后指标，可以筛选HCC肝移植受体。Objective To explore the feasibility of 18 F-fluorodeoxyglucose （ FDG） positron emission tomography/computed tomography （ PET/CT） in proposing selection criteria for patients with hepatocellular carcinoma （ HCC） in liver transplantation.Methods We respectively analyzed 31 cases of HCC patients from our hospital and those accepting no anti-tumor therapy or orthotopic liver transplantation before 18 F-FDG PET/CT examination.The T/B value was set as a semi-quantitative parameter reflecting the metabolic activities of tumors.And receiver operating characteristic （ ROC） curve was plotted to determine the optimal cutoff value of T/B affecting HCC recurrence after transplantation.Their clinicopathological features were analyzed by univariate and multivariate analyses to determine the risk factors for HCC recurrence after transplantation.Results During the follow-up period , the total incidence of tumor recurrence or metastasis was 51.6%.And the disease-free survival rates of 6 months, 1 year and 2 years post-transplantation were 93.5%, 67.7% and 46.8% respectively.The univariate analysis revealed 4 variables of affecting the recurrence or metastasis of HCC after transplantation , namely T/B value, tumor size, tumor number and preoperative alpha fetoprotein （ AFP） level.While multivariate analyses indicated that T/B value and tumor size were independent factors.Conclusion T/B value, tumor number and preoperative AFP level were independent risk factors for tumor recurrence.As a prognostic indicator of tumor biological behavior , 18 F-FDG PET/CT can identify the eligible transplant HCC candidates.

关 键 词：癌 肝细胞 氟脱氧葡萄糖F18 肝移植 

分 类 号：R735.7[医药卫生—肿瘤] R730.44[医药卫生—临床医学]