^(18)F-FDG PET/CT代谢指标预测胃肠道间质瘤恶性危险度  

Predictive value of ^(18)F-FDG PET/CT metabolic parameters in patients with gastrointestinal stromal tumors

作　　者：李囡[1] 范洋 翟士桢[1] 关湘萍 于江媛[1] 周妮娜[1] 郭锐 王菲[1] 苏华[1] 张岩[1] 赵伟[1] 杨志[1] Li Nan;Fan Yang;Zhai Shizhen;Guan Xiangping;Yu Jiangyuan;Zhou Nina;Guo Rui;Wang Fei;Su Hua;Zhang Yan;Zhao Wei;Yang Zhi(Department of Nuclear Medicine,Peking University Cancer Hospital & Institute,Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education),Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科恶性肿瘤发病机制及转化研究教育部重点实验室,100142

出　　处：《中华临床医师杂志（电子版）》2018年第8期432-439,共8页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的探讨^(18)F-脱氧葡萄糖正电子发射计算机体层显像仪(^(18)F-FDG PET/CT)代谢指标对胃肠道间质瘤(GIST)恶性危险度的预测价值。方法回顾性分析2010年11月至2017年12月北京大学肿瘤医院44例GIST患者^(18)F-FDG PET/CT术前显像及手术病理结果等临床病理资料。对于^(18)F-FDG PET/CT显像阳性和阴性患者,应用χ~2检验分析患者性别、年龄、病变部位、肿瘤直径、淋巴结转移、脏器转移、核分裂象、Ki-67指数、CD117和CD34表达、美国国立卫生研究院(NIH)危险度分级以及世界卫生组织(WHO)肿瘤预后分组等临床病理参数。对于^(18)F-FDG PET/CT显像阳性患者,应用非参数秩和检验分析不同临床特征(性别、年龄、病变部位、肿瘤直径、病变密度、淋巴结或脏器转移情况)和不同病理特征(核分裂象、CD34表达情况、Ki-67指数、NIH危险度分级以及WHO肿瘤预后分组)患者3种PET/CT代谢指标,即最大标准摄取值(SUVmax)、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)。采用Pearson相关分析分析SUVmax、MTV、TLG与GIST恶性危险度的相关性。结果 44例GIST患者中^(18)F-FDG PET/CT显像阳性者31例,阴性者13例,显像阳性率为70.5%。显像阳性和显像阴性患者在肿瘤直径、核分裂象、Ki-67指数、NIH危险度分级、WHO肿瘤预后分组方面的差异均有统计学意义(χ~2=13.926,P=0.003;χ~2=7.738,P=0.021;χ~2=4.233,P=0.040;χ~2=24.670,P <0.001;χ~2=24.670,P <0.001),而在性别、年龄、病变部位、淋巴结转移、脏器转移、CD117和CD34表达方面差异均无统计学意义(P均> 0.05)。31例^(18)F-FDG PET/CT显像阳性者中,肿瘤直径≤5 cm患者与> 5 cm患者比较,MTV(P=0.003)和TLG(P=0.004)的差异具有统计学意义,而SUVmax的差异无统计学意义(P> 0.05)。核分裂象≤5/50HPF和> 5/50HPF的患者,Ki-67指数≤5%和> 5%的患者,以及不同NIH危险度分级、WHO肿瘤预后分组的患者,其SUVmax(P=0.022,0.023,0.016,0.016)、MTV(P=0.03Objective To assess the predictive value of 18F-FDG PET/CT metabolic parameters in patients with gastrointestinal stromal tumors(GISTs).Methods The preoperative 18F-FDG PET/CT imaging and surgical pathological data of 44 patients with GISTs treated at Beijing Cancer Hospital from November 2010 to December 2017 were analyzed retrospectively.Clinicopathological parameters such as sex,age,lesion location,tumor diameter,lymph node metastasis,organ metastasis,mitotic figure,Ki-67 index,CD117 and CD34 expression,NIH risk classification,and WHO prognosis were analyzed by the Chi-square test in patients with positive and negative 18F-FDG PET/CT imaging results.In patients with positive 18F-FDG PET/ CT imaging results,three PET/CT metabolic indexes(SUVmax,MTV,and TLG)were analyzed by the nonparametric rank sum test in different groups with different clinical or pathological features.Results Thirtyone cases had positive 18F-FDG PET/CT imaging results and 13 cases had negative results.The Chi-square test showed that there were significant differences between the two groups with regard to tumor diameter,mitotic figures,Ki-67 index,NIH risk classification,and WHO prognosis(χ^2=13.926,P=0.003;χ^2=7.738,P=0.021;χ^2=4.233,P=0.040;χ^2=24.670,P<0.001;χ^2=24.670,P<0.001),but there was no significant difference in sex,age,lesion location,lymph node or organ metastasis,or expression of CD117 and CD34(P>0.05 for all).Among the 31 18F-FDG PET/CT positive cases,MTV and TLG differed significantly between patients with tumor diameter≤5 cm and>5 cm(P=0.003 and 0.004,respectively),but the difference of SUVmax was not significant(P>0.05).SUVmax(P=0.022,0.023,0.016,0.016),MTV(P=0.038,0.028,0.004,0.004),and TLG(P=0.025,0.014,0.004,0.004)differed significantly between patients with different mitotic figures(≤5/50 HPF vs>5/50 HPF),Ki-67 index(≤5% vs>5%),NIH risk classification,or WHO prognosis,while no significant difference was found between patients with different sexes,age(≤60 vs>60 years old),lesion site or density,CD34 expressi

关 键 词：18F-脱氧葡萄糖正电子发射计算机体层显像仪 胃肠道间质瘤 恶性危险度分级 

分 类 号：R735[医药卫生—肿瘤] R730.44[医药卫生—临床医学]