^18氟-氟代脱氧葡萄糖PET／CT检查在胃癌与原发性胃淋巴瘤鉴别诊断中的应用  

Value of ^18F-FDG PET/CT examination in the differential diagnosis of gastric cancer and primary gastric lymphoma

作　　者：左聪[1] 徐文贵[1] 戴东[1] 宋秀宇[1] 

机构地区：[1]天津医科大学肿瘤医院分子影像与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：《中华消化外科杂志》2015年第3期216-220,共5页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金青年基金（81302003）;天津市教委课题（200120109）;天津市肿瘤医院基金（Y1310）;天津市卫生局科技基金（2013KZ088）

摘　　要：目的探讨^18氟-氟代脱氧葡萄糖（^18F—FDG）PET／CT检查在胃癌与原发性胃淋巴瘤（PGL）鉴别诊断中的价值。方法回顾性分析2006年6月至2014年5月天津医科大学肿瘤医院收治的80例胃癌（60例胃非黏液腺癌、20例胃黏液腺癌）患者和47例PGL[22例黏膜相关淋巴瘤（MALT）、25例弥漫性大B细胞淋巴瘤（DLBCL）]患者的临床资料。首先行螺旋CT扫描，后行PET采集。对CT值、最大标准摄取值（SUVmax）、病灶最大厚度之间的比较采用方差分析，其中两组问的SUVmax值比较采用SNK方法；病灶形态采用，检验；病灶最大厚度与SUVmax值相关性采用两变量Pearson相关分析。结果胃癌及PGL患者的PET／CT检查结果均可表现为不同形式的胃壁增厚，胃癌以节段性或局限性胃壁增厚多见，而PGL以弥漫性或节段性胃壁增厚多见。60例胃非黏液腺癌患者病灶形态Ⅰ、Ⅱ、Ⅲ型分别为12、21、27例，20例胃黏液腺癌患者分别为2、7、11例，22例MALT患者分别为8、8、6例，25例DLBCL患者分别为13、7、5例。4类不同病理学分型患者的病灶形态比较，差异有统计学意义（χ^2=14．849，P〈0．05）。胃癌患者中，7例合并脾肿大，16例累及腹膜后肾门下淋巴结。PGL患者中，12例合并脾脏肿大，10例累及腹膜后肾门下淋巴结。PGL患者较胃癌患者更容易出现脾肿大，两者比较，差异有统计学意义（χ^2=7．506，P〈0．05）。胃癌与PGL患者在腹膜后肾门下淋巴结转移方面比较，差异无统计学意义（χ^2=0．178，P〉0．05）。80例胃癌患者中，79例表现为^18F—FDG阳性，仅1例胃黏液腺癌患者表现为^18F—FDG阴性，分期为仍期。47例PGL患者中，46例表现为^18F—FDG阳性，仅1例MALT患者表现为^18F—FDG阴性，分期为I期。胃非黏液腺癌、胃黏液腺癌、MALT和DLBCL患者CT值、SUVmax值、病灶最大厚度分别为（40±8）HU、（39±11）HU、（41±11）HObjective To explore the value of ^18F-fluorodeoxyglucose （^18F-FDG） PET/CT examination in the differential diagnosis of the gastric cancer and primary gastric lymphoma （PGL）. Methods The clinical data of 80 patients with gastric cancer （60 with non-mucinous adenocarcinoma and 20 with mucinous adenocarcinoma） and 47 patients with PGL [ 22 with mucosa-associated lymphoid tissue （MALT） and 25 with diffuse large B-cell lymphoma （DLBCL）] who were admitted to the Tianjin Medical University Cancer Institute and Hospital from June 2006 to May 2014 were retrospectively analyzed. Spiral CT scan was first done and then followed by PET.The CT value of the lesions, maximum standardized uptake value （SUVmax） of patients and maximal gastrointestinal wall thickness （THKmax） were analyzed by the ANOVA test. The SUVmax comparison between groups was evaluated with the Student-Newman-Keuls. The lesions type was analyzed by the chi-square test. The THKmax and SUVmax among groups were analyzed by the Pearson correlation analysis. Results ^18F-FDG PET/CT imaging of patients with gastric cancer and PGL showed different types of gastric wall thickening, segmental and limited thickening of gastric wall were the main features of gastric cancer and diffuse and segmental thickening of gastric wall were the main features of PGL. The type Ⅰ , Ⅱ and m of lesions were detected in 12, 21 and 27 of 60 patients with non- mucinous adenocarcinoma, in 2, 7 and 11 of 20 patients with mucinous adenocarcinoma, in 8, 8 and 6 of 22 patients with MALT and in 13, 7 and 5 of 25 patients with DLBCL respectively. There were significant differences in the 4 pathological types of lesions among all the patients （χ^2= 14. 849, P 〈 0.05 ）. The lymph nodes beneath the renal hilum and at the retroperitoneum were involved in 16 patients with gastric cancer and in 10 patients with PGL, and 7 patients with gastric cancer and 12 patients with PGL were complicated with splenomegalia, respec- tively, showing a significant difference i

关 键 词：胃肿瘤 胃淋巴瘤 体层摄影术 正电子发射断层显影术 最大摄取值 

分 类 号：R735.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]