^(18)F-FDG PET/CT在直肠癌中的临床应用价值  

^(18)F-FDG PET/CT in Diagnosis of Rectal Cancer

作　　者：陈暮楠 梁邦玉 于丽娟[1] 赵升[1] 

机构地区：[1]哈尔滨医科大学附属肿瘤医院,黑龙江哈尔滨150081

出　　处：《肿瘤学杂志》2017年第2期101-105,共5页Journal of Chinese Oncology

基　　金：黑龙江省自然基金重点项目(ZD2015017)

摘　　要：[目的]通过测量直肠癌原发病灶^(18)F-FDG PET/CT的代谢参数,探讨其在诊断直肠癌转移上的临床应用价值。[方法]回顾性分析经病理证实为直肠癌并行全身^(18)FDG PET/CT显像的患者79例,术前未行其他治疗。记录患者年龄、性别、CEA、病理类型、病变部位、T分期、原发灶的密度、最大径、最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)和总糖酵解量(TLG);根据病理结果和其他影像学检查验证是否存在转移灶。采用单因素方差分析法分析有转移组和无转移组原发灶各参数与转移的关系;多因素二元Logistic回归分析观察代谢参数与转移的关系,排除混杂因素并筛选诊断转移的独立影响因素;ROC曲线分别分析有统计学意义的因素诊断直肠癌转移的效能。[结果]单因素分析结果显示CEA、原发灶CT值、MTV和TLG与转移有关(P均<0.05)。多因素Logistic回归分析结果显示仅CEA和原发灶TLG与转移有关(P=0.035、0.018)。分别绘制CEA、TLG和CEA联合TLG诊断直肠癌患者转移的ROC曲线,三者预测直肠癌转移的ROC曲线下面积分别为0.684、0.855和0.842;诊断转移的灵敏度分别为72.2%、94.4%和75.0%,特异性分别为62.8%、76.7%和81.1%,准确性分别为68.4%、78.5%和78.5%。[结论]直肠癌患者血清CEA、原发灶CT值、MTV和TLG与转移存在相关性。血清CEA和原发灶TLG是诊断转移的独立因素。CEA联合TLG诊断转移效能并不优于TLG独立诊断转移。TLG作为诊断直肠癌转移的因素,有较好的准确性,可为临床制定合理治疗方案提供帮助。[Objective] To evaluate the application of 18F-FDG PET/CT in diagnosis of the rectal cancer [Methods] Seventy nine patients with rectal cancer underwent 18F-FDG PET/CT examination before operation. The age,gender,serum carcinoembryonic antigen（CEA） levels,pathological types,tumor site,T-staging,density of primary lesion,maximum diameter were documented,and the PET/CT parameters maximum standardized uptake value（SUVmax）,metabolic tumor volume（MTV） and total lesion glycolysis（TLG） were calculated. The relationship of metabolic parameters on PET/CT with the metastasis of rectal cancer was studied by univariate analysis multivariate binary Logistic regression analysis. The predictive value of PET/CT parameters for metastasis of rectal cancer was analyzed by the ROC curve. [Results] Univariate ANOVA revealed that CEA,CT values of primary lesion MTV and TLG were correlated with the metastasis（F =10.711,19.086,31.896,P 〈0.05,respectively）. Multivariate binary Logistic regression analysis showed that only CEA and TLG were correlated with metastasis（OR=3.852,95%CI：1.09613.542,P=0.035;OR=1.006,95%CI：1.0011.011,P=0.018）. The area under ROC curve of CEA,TLG and CEA combined with TLG to predict metastasis of rectal carcinoma were 0.684,0.855 and 0.842,respectively. Correspondingly,the sensitivity was 72.2%,94.4%,and 75.0%;specificity was 62.8%,76.7% and 81.1%;and the accuracy was 68.4%,78.5% and 78.5%,respectively. [Conclusion]Serum CEA,CT value,PET/CT parameters MTV and TLG of primary lesion are correlated with the metastasis of rectal cancer,the TLG value has better diagnostic accuracy than other parameters.

关 键 词：正电子发射体层显像 计算机体层成像 直肠肿瘤 转移 总糖酵解量 

分 类 号：R735.37[医药卫生—肿瘤]