^(18)F-FDG PET/CT半定量参数SUVmax对肾透明细胞癌分级分期的预测价值  

Correlation of SUVmax of ^(18)F-FDG PET/CT Scan with Nuclear Grade and Pathological Stage of Renal Clear Cell Carcinoma

作　　者：邸丽娟[1] 王荣福[1] 张建华[1] 赵光宇[1] 刘萌[1] 崔永刚[1] 郭凤琴[1] 陈立新[1] 姜巧[1] DI Li-juan WANG Rong-fu ZHANG Jian-hua et al(Peking University First Hospital ,Beijing 100034, China)

机构地区：[1]北京大学第一医院,北京100034

出　　处：《肿瘤学杂志》2017年第4期295-299,共5页Journal of Chinese Oncology

基　　金：国家重大科学仪器设备开发专项(2011YQ03011409);国家"十二五"支撑项目基金(2014BAA03B03)

摘　　要：[目的]分析^(18)F-FDG PET/CT葡萄糖代谢活性参数最大标准摄取比值(maximum of standardized uptake value,SUVmax)对肾透明细胞癌分级、分期的预测价值。[方法 ]回顾性分析行^(18)F-FDG PET/CT检查的51例肾透明细胞癌患者(Fuhrman分级G_1级16例、G_2级23例、G_3级和G_4级12例;pT分期为1和2期29例,3和4期13例),所有患者经手术或穿刺病理证实为透明细胞癌,根据^(18)F-FDG PET/CT图像,测定葡萄糖代谢参数SUVmax和肿瘤直径。分析不同Fuhrman分级、pT分期病灶的SUVmax差异情况,以及肿瘤的SUVmax与其大小的相关性。[结果]G_1级、G_2级、G_3级与G_4级三组病灶SUVmax中位数分别为2.15(1.83~2.83)、3.60(2.40~6.30)、10.05(7.73~14.08),差异有统计学意义(χ~2=26.11,P<0.001)。以6.65为界值,SUVmax≥6.65时,鉴别高级别肾透明细胞癌(G_3、G_4)的灵敏度和特异性分别为91.7%、84.7%,曲线下面积为0.938(P<0.001)。pT分期早期(1、2期)与晚期(3、4期)组SUVmax中位数分别为2.30(1.80~2.80)、6.00(3.90~11.10),差异有统计学意义(Z=-3.98,P<0.001)。以3.10为界值,SUVmax≥3.10时,鉴别晚期肾透明细胞癌(pT3期、pT4期)的灵敏度和特异性分别是94.7%、87.0%,曲线下面积为0.860(P<0.001)。病灶的SUVmax(1.5~17.7)与肿瘤的直径(0.70~17.70cm)有一定程度的正相关(r=0.62,P<0.001)。[结论 ]肾透明细胞癌的SUVmax与肿瘤Fuhrman分级、pT分期有一定关系,利用SUVmax,^(18)F-FDG PET/CT可以预测肿瘤的分级和分期。[Objective] To evaluate the correlation of maximum standardized uptake value（SUVmax） in^18F-FDG PET/CT scan with the nuclear grade and pathological stage of renal clear cell carcinoma（cc RCC）. [Methods] Fifty one patients with nephrectomy or tissue biopsy-proved cc RCC（including 16 G1,23 G2,12 G3 and G4;29 early stage with pT1 and pT2,13 late-stage with pT3 and pT4） underwent^18F-FDG PET/CT examination. The SUVmax and tumor diameter were evaluated by PET/CT. The correlations of SUVmax with tumor diameter and pathologic parameters Fuhrman grades,pT stages were analyzed. [Results] The median SUVmax of G1（n=16）,G2（n=12）,G3 and G4（n=23） tumor was 2.15（1.83-2.83）,3.60（2.40-6.30） and 10.05（7.73-14.08）,respectively（χ^2=26.11,P〈0.001）. With the cutoff value of 6.65,the sensitivity and specificity of SUVmax in differentiating high-grade（G3and G4） from low-grade（G1and G2） cc RCC were 91.7% and 84.7%（AUC was 0.938,P〈0.001）,respectivley. The median SUVmax of early-stage and late-stage tumor was 2.30（1.80-2.80） and 6.00（3.90-11.10）,respectively（Z=-3.98,P〈0.001）. With the cutoff value of 3.10,the sensitivity and specificity of SUVmax in differentiating late-stage from early-stage cc RCC were 94.7% and 87.0%,respectively（AUC was 0.860,P〈0.001）. The spearman correlation？coefficient between tumor diameter and SUVmax was 0.62（P〈0.001）. [Conclusion] Higher FDG uptake suggests a high-grade and late pT stage cc RCC. Using SUVmax,^18F-FDG PET/CT may indicate pathological grade and stage of cc RCC.

关 键 词：肾透明细胞癌 标准摄取比值 正电子发射型计算机断层扫描 分级 分期 

分 类 号：R737.11[医药卫生—肿瘤]