^(18)F-FDG PET/CT在阿帕替尼治疗肺多发转移性碘难治性分化型甲状腺癌评估中的价值  

The value of ^(18)F-FDG PET/CT in the evaluation of multiple lung metastatic radioactive iodinerefractory differentiated thyroid cancer after apatinib therapy

作　　者：张迎强[1,2] 张鑫 王宸[1,2] 李慧 刘延晴[1,2] 管文敏 王雷[3] 林岩松 ZHANG Yingqiang;ZHANG Xin;WANG Chen;LI Huil,;LIU Yanqing;GUAN Wenmin;WANG Lei;LIN Yansong(Department of Nuclear Medicine,Peking Union Medical College Hospital,Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China;Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,Beijing 100730,China;Department of Radiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China）Correspondence to： LIN Yansong E-mail： [e-mail])

机构地区：[1]中国医学科学院北京协和医学院北京协和医院核医学科,北京100730 [2]核医学分子靶向诊疗北京市重点实验室,北京100730 [3]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《中国癌症杂志》2018年第7期505-510,共6页China Oncology

基　　金：国家自然科学基金(81571717;81771875);中国医学科学院医学与健康科技创新工程(2016-I2M-2-006)

摘　　要：背景与目的:碘难治性分化型甲状腺癌(radioactive iodine-refractory differentiated thyroid cancer,RAIR-DTC)是近年来研究的热点。因肿瘤细胞的异质性,不同病灶的生长速度及治疗疗效不尽相同。该研究探讨^(18)F-FDG PET/CT在RAIR-DTC多发肺转移患者经阿帕替尼治疗效果评估中的价值。方法:纳入于中国医学科学院北京协和医学院北京协和医院经阿帕替尼治疗的RAIRD TC患者。入组患者于基线、治疗后4周及8周行CT及^(18)F-FDG PET/CT检查。结果:共7例患者,4 9个肺转移灶,SUV_(max)在基线时为0.8~23.2。基线时病灶的SUV_(max)水平与治疗后4周及8周的SUV_(max)变化(SUV_(max-4w)/SUV_(max-baseline)),SUV_(max-8w)/SUV_(max-baseline))显著相关(P<0.000 1,P<0.000 1)。4周及8周的病灶直径变化率(CT4w/b,CT8w/b)与基线SUV_(max)无明显线性相关(P=0.666 4,P=0.478 7)。而4周的SUV_(max)变化(SUV_(max-4w)/SUV_(max-baseline))与CT4w/b及CT8w/b显著相关(P=0.033 3,P=0.004 8)。对于基线水平SUV_(max)大于5的病灶,SUV_(max-baseline)与CT4w/b、CT8w/b均具有线性关系(P=0.008 2,P=0.016 9)。结论:^(18)F-FDG PET/CT在RAIR-DTC多发肺转移患者靶向药物治疗中具有广阔的应用前景,可以识别肿瘤一致性,辅助选取靶病灶,并通过病灶的SUV_(max)预测患者对靶向药物治疗的疗效。Background and purpose： Radioactive iodine-refractory differentiated thyroid cancer（RAIR-DTC） is a hot topic in recent years. The growth rates of different lesions and their responses to treatment vary a lot due to the heterogeneity of tumor cells. This study aimed to explore the value of ^（18）F-FDG PET/CT in RAIR-DTC after the therapy of apatinib. Methods： RAIR-DTC patients undergoing apatinib therapy in Peking Union Medical College Hospital wereenrolled. ^（18）F-FDG PET/CT was performed at baseline, 4 weeks and 8 weeks after apatinib therapy. Results： A total of 7 patients including 49 lung metastases were analyzed after apatinib therapy, with SUV（max） varying from 0.8 to 23.2. The results showed that the SUV（max） level of lesions at baseline was significantly associated with the changes in SUV（max） at 4 and 8 weeks after the treatment（SUV（max-4 w）/SUV（max-baseline）, SUV（max-8 w）/SUV（max-baseline））（P0.000 1, P0.000 1）. The rate of lesion diameter change（CT4 w/b, CT8 w/b） was not correlated with baseline SUV（max） at 4 weeks and 8 weeks（P=0.666 4, P=0.478 7）. The 4-week change in SUV（max）（SUV（max-4 w）/SUV（max-baseline）） was significantly associated with CT4 w/b and CT8 w/b（P=0.033 3, P=0.004 8）. For lesions with baseline SUV（max） greater than 5, SUV（max-baseline） had a linear relationship with CT4 w/b and CT8 w/b（P=0.008 2, P=0.016 9）. Conclusion： ^（18）F-FDG PET/CT has great value in evaluating the heterogeneity, selecting target lesions and predicting the response in patients with RAIR-DTC after apatinib therapy.

关 键 词：碘难治性分化型甲状腺癌 18F-FDG PET/CT 阿帕替尼 疗效评估 

分 类 号：R73-37[医药卫生—肿瘤]