肺腺癌EGFR19及21外显子基因型与18F-FDG摄取程度的关系研究  

Correlation of epidermal growth factor receptor mutation( 19 and 21 exon) and ^(18)F-fluorodeoxyglucose uptake in patients with surgical resected adenocarcinoma: on the basis of the 2011 IASLC/ATS/ERS adenocarcinoma classification

作　　者：易婧薇 陈仰纯 李凡勇[1] 顾霞[3] 陈萍[1] YI Jingwei;CHEN Yangchun;LI Fanyong;GU Xia;CHEN Ping(PET/CT Center, The First affiliated Hospital of Guangzhou Medical University, Guangzhou 510230, Chin)

机构地区：[1]广州医科大学附属第一医院PET/CT,510230 [2]泉州市第一医院核医学科 [3]广州医科大学附属第一医院病理科,510230

出　　处：《心肺血管病杂志》2018年第3期248-252,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:关于肺癌EGFR基因型与18F-FDG(18F-Fluorodeoxyglucose)摄取的关系仍众说纷纭。本文采用肺腺癌原发灶手术切除标本,根据2011年IASLC/ATS/ERS肺腺癌病理分型,探讨肺腺癌不同病理亚型EGFR19及21外显子基因型与^(18)F-FDG摄取程度的相关性。方法:回顾性分析79例肺腺癌患者的术前PET/CT图像、原发灶病理亚型及EGFR19及21外显子基因型。采用协方差分析比较不同病理亚型、不同基因型原发灶的^(18)F-FDG的摄取程度。结果:腺癌各亚型的葡萄糖摄取程度不同,其中实体为主型(Ln SUV)最高,微小浸润与贴壁生长为主型Ln SUV最低,浸润性粘液腺癌SUV居前两者之间,乳头为主及腺泡为主型SUV相近,较前述后两者高。但通过SUV不能有效区别各病理亚型下病灶的EGFR基因型。结论:肺腺癌的^(18)F-FDG代谢程度与病理类型有关,实体生长为主型的糖代谢最高,微小浸润型腺癌及贴壁生长型腺癌的糖代谢最低,浸润性粘液腺癌SUV居前两者之间。但腺癌各病理亚型原发灶的葡萄糖摄取程度与其EGFR19及21外显子基因型无关,不能通过^(18)F-FDG的SUV值来预测EGFR是否存在这两个外显子突变,二者是独立的生物学指标,反应肿瘤不同的生物学信息。Objective： Previous result about the correlation of epidermal growth factor receptor（ EGFR） genotype and standardized uptake value（ SUV） of ^（18） F-fluoro-2-deoxy-glucose（^（18） F-FDG） uptake in patients with non-small cell lung cancer were not in accordance. The aim of this study is tried to confirm the correlation between FDG uptake and the EGFR genotype（ 19 and 21 exon） among different histopathologic subtypes of adenocarcinoma according to the 2011 IASLC/ATS/ERS adenocarcinoma classification. Methods： We retrospectively analyzed 79 adenocarcinoma patients who both had pretreatment PET/CT and EGFR mutation testing（ 19 and 21 exon） from Jan 2009 to March 2012. All the tumor samples were obtained by surgery. The subtypes of adenocarcinoma were defined by two experienced pathological physicians. EGFR mutation status was assessed by PCR amplification. PET/CT images were analyzed by two PET/CT physicians. SUVmax and SUVmean were obtained automatically by software. Results： Comparable differences were observed for the Ln SUVmax and LnSUVmean of the six subtypes of lung adenocarcinomas. Moreover,the solid type gained the highest Ln SUVmax and Ln SUVmean while the minimally invasive adenocarcinoma and the tumors of lepidic predominant pattern got the lowest. The invasive mucinous adenocarcinomas was higher than former two subtypes. The acinar patterns and papillary patterns got similar Ln SUV. Tumors with acinar patterns had higher^（18） F-FDG uptake than. EGFR mutation status of different pathological subtypes showed no influence of SUVmax and SUVmean. Conclusion：The lepidic pattern and invasive mucinous adenocarcinoma had the lowest^（18） F-FDG uptake while the solid typegot the highest,while the invasive mucinous adenocarcinomas was in the middle. However,no correlation was observed between the EFGR status of 19 and 21 exons and SUV in different histopathologic subtypes of adenocarcinoma regarding to tumor size,indicating the genotype of EGFR and the metabolism of glucose we

关 键 词：表皮生长因子受体 ^(18)F-脱氧葡萄糖 体层摄影术 发射型计算机 肺腺癌 

分 类 号：R56[医药卫生—呼吸系统]