^(18)F-FLT和^(18)F-FDG对孤立性肺结节诊断效能分析  

Diagnostic performance of ^(18)F-FLT and ^(18)F-FDG in the solitary pulmonary nodules

作　　者：李天然[1] 谭业颖[2] 霍天龙[3] 卢光明 杜湘珂[3] 赵周社 

机构地区：[1]福建医科大学福州总医院临床医学院第一附属医院放射科,福建莆田351100 [2]江苏省徐州市中心医院PET/CT中心,江苏徐州221009 [3]北京大学人民医院放射科,北京100048 [4]南京总医院放射科,南京210002 [5]GE医疗(中国)有限公司,北京100048

出　　处：《中国医药科学》2015年第17期9-15,共7页China Medicine And Pharmacy

基　　金：国家自然科学基金资助项目(81271607);福建省自然科学基金资助项目(2013J01392)

摘　　要：目的探讨18F-FLT与18F-FDG联合显像对孤立性肺结节的诊断价值。方法 A549细胞与两种示踪剂分别进行结合实验,分析两者结合率差异,结合率与Ki-67的相关性。55例肺部SPN患者18F-FLT、18FFDGPET/CT联合显像资料,以术后病理为"金标准",分析两种示踪剂对SPN的诊断效能,观察病灶SUV与病理组织Ki-67的相关性。结果 A549细胞对FDG的平均摄取率高于对FLT的平均摄取率(P<0.05),肺癌A549细胞的增殖指数Ki-67与FDG的摄取率无明显的相关性(P>0.05),而与FLT的摄取率有明显的正相关性(r=0.824,P<0.01)。18F-FDG诊断肺癌的灵敏度为89%,特异度67%,准确性73%。18F-FLT诊断肺癌的灵敏度为71%、特异度79%、准确性76%。FDG在肺脏孤立性肺结节对示踪剂的摄取优于FLT,FLT对原发性肺癌的显示优于对其他病变的显示,FDG对原发性肺癌和结核的显示优于对感染和良性病变的显示。肺癌组织的增殖指数Ki-67与FDG的摄取率呈明显的正相关性(r=0.658,P<0.05),且与FLT的摄取率有明显的正相关性(r=0.724,P<0.01)。结论 A549细胞和SPN对18F-FDG摄取率高于18F-FLT,18F-FLT对肺癌特异性高于18F-FDG,两种示踪剂的联合使用可以提高肺癌诊断的特异性和准确性。Objective To explore the diagnostic value of ^18F-FLT and ^18F-FDGin the diagnosis of solitary pulmonary nodules（SPN）. Methods A549 cells banded with two tracers experiment respectively in vitro, and cellstracers binding ratios difference is analyzed, and the correlation of tracers binding ratios with Ki-67 is analyzed. Imaging data of 55 patients with SPN who were examined by ^18F-FLT and ^18F-FDGPET/CT were collected, with pathological results as the gold standard. We explored the diagnostic value of ^18F-FLT and ^18F-FDG in the diagnosis of solitary pulmonary nodules and the correlation of SUV with Ki-67. Results ^18F-FDG uptake rate of A549 cells is higher than ^18F-FLT uptake rate（P〈0.05）. There was no correlation between ^18F-FDG uptake ratio and proliferation index Ki-67 of A549 cells（P〉0.05）, but the proliferation index Ki-67 had significant positive correlation with ^18F-FLT uptake rate（r=0.824, P〈0.824）.Diagnostic sensitivity of ^18F-FDGfor lung cancer was 89%, and the specificity was 67%, and accuracy was73%.Diagnostic sensitivity of ^18F-FLT for lung cancer was 89%, and the specificity was 67%, and accuracy was 73%.^18F-FDG uptake ratio of SPN is higher than that ^18F-FLT ratio, and ^18F-FLT for primary lung cancer display was superior to for other lesions. ^18F-FDG for primary lung cancer and tuberculosis display was superior to for infection and benign lesions. There was obviously positive correlation between lung cancer proliferation index of Ki-67 and ^18F-FDG uptake ratio（r=0.658, P〈0.05）, and ^18F-FLT uptake ratio（r=0.724, P〈0.01）. Conclusion ^18F-FDG uptake rateof A549 cells and SPN are higher than ^18F-FLT uptake rate. Diagnostic specificity of ^18F-FLT for lung cancer is higher than 18 FFDG.A combination of two tracers can improve the diagnostic specificity and accuracy of lung cancer

关 键 词：肺癌 ^18F-FLT ^18F-FDG SUV 孤立性肺结节 

分 类 号：R445[医药卫生—影像医学与核医学]