^18F—FDG PET／CT显像对原发性肝癌分化程度和临床分期的评估价值  

The value of ^18 F-FDG PET/CT image in differentiation and clinical staging of primary liver cancer

作　　者：白璐[1] 尚进[1] 刘翔[1] 马春玲[1] 郭佑民[1] 段小艺[1] 

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061

出　　处：《实用放射学杂志》2015年第12期2037-2040,2045,共5页Journal of Practical Radiology

基　　金：国家自然科学基金（面上项目）资助项目（81471710）.

摘　　要：目的 通过与相关血清肿瘤标志物检测的比较，探索18F-脱氧葡萄糖正电子发射计算机断层扫描（18F-FDG PET/CT）对原发性肝癌（PLC）分化程度和临床分期的评估价值。方法 回顾性收集本院96例初诊PLC患者的PET/CT显像与血清甲胎蛋白（AFP）、癌胚抗原（CEA）和糖类抗原199（CA199）的检测结果，依其临床特征及病理参数分组，观察不同组别间最大标准化摄取值（SUVmax）的差异，并与组间肿瘤标志物水平的差异进行比较。结果 年龄和性别不影响血清肿瘤标志物水平；SUVmax受肿瘤大小影响明显（P〈0.01），但不受肿瘤标志物影响（P〉0.05）。胆管细胞型肝癌患者的CEA水平显著低于肝细胞型（P〈0.01），而血清AFP、CA199水平与SUVmax则在不同细胞类型的组间无统计学差异（P〉0.05）。血清AFP与PLC的分化程度有关，SUVmax、血清CEA水平与肿瘤临床分期有关（P〈0.05）。另外，肿瘤SUVmax与血清CEA和AFP水平呈正相关（P〈0.01）。结论 血清AFP水平能够预测肝细胞肝癌的分化程度，而SUVmax、CEA与PLC的临床分期有一定关系，且SUVmax受肿瘤大小影响；SUVmax与血清CEA和AFP水平呈正相关。因此，18F-FDG PET/CT成像与肝癌相关肿瘤标志物对PLC患者预后有一定价值。Objective To explore the value of ^18F-FDG PET/CT image in assessment of differentiation and clinical staging of primary liver cancer （PLC） in comparison with serum tumor markers. Methods The data of 96 patients diagnosed as PLC were collected retrospectively,including ^18 F-FDG PET/CT images and relevant tumor markers （AFP, CEA and CA199）. Then different groups were divided according to the clinical features and pathological types of PLC. We compared different groups＇ SUVmaxes with tumor markers for exploring the relationship between two groups above. Results There were no relationship between the patient＇s age or gender and serum tumor marker levels. SUVmax was significantly influenced by tumor size （P〈0.01）, but not by the tumor markers （P〈0.05）. The CEA level of cholangiocarcinoma was significantly lower than that of hepatocellular carcinoma （P〈0.01）, and the AFP, CA199 or SUVmax showed no statistical differences in different cell type groups （P〉0.05）. AFP was associated with the differentiation of PLC, and the SUVmax and CEA level was associated with the clinical staging （P〈0.05）. In addition, the tumor SUVmax was positively correlated with CEA and AFP levels （P〈0.01）. Conclusion The level of serum AFP can predict the differentiation of hepatocellular carcinoma, meanwhile SUVmax and CEA have a certain relationship with clinical staging of PLC, and SUVmax is affected by tumor size. SUVmax is positively correlated with serum CEA and AFP levels. ^18 F-FDG PET/CT image and PLC relevant tumor markers play important roles in patients＇ diagnosis.

关 键 词：原发性肝癌 正电子发射计算机断层显像 ^18F-脱氧葡萄糖 血清肿瘤标志物 标准摄取值 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]