肺癌18F-FDG PET/CT代谢特征与肿瘤标志物的相关性  

Correlation Between 18F-FDG PET/CT Metabolic Characteristics of Lung Cancer and Tumor Markers

作　　者：王慧春[1] 王玉斌[1] 崔兰兰[1] 陈晓红[1] 虎维东[2] WANG Huichun;WANG Yubin;CUI Lanlan;CHEN Xiaohong;HU Weidong(Department of Respiratory,Gansu Provincial Hospital,Lanzhou 730000,China;不详)

机构地区：[1]甘肃省人民医院PET/CT中心,甘肃兰州730000 [2]甘肃省人民医院呼吸科,甘肃兰州730000

出　　处：《中国医学影像学杂志》2020年第5期343-348,共6页Chinese Journal of Medical Imaging

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2016-05)。

摘　　要：目的分析肺癌原发灶的18F-FDG PET/CT代谢参数与血清肿瘤标志物的关系,以及两者在Ⅰa~Ⅲa期与Ⅲb~Ⅳb期肺癌中的差异。资料与方法回顾性分析97例行18F-FDG PET/CT检查的初诊肺癌患者,测量原发灶直径、最大标准化摄取值(SUVmax)、代谢体积(MTV)与病灶糖酵解总量(TLG),检测肺癌血清标志物癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)、鳞状上皮细胞癌抗原(SCCA)、胃泌素释放肽前体(Pro-GRP)。以PET/CT分期结果为主要依据,综合患者临床资料进行TNM分期。根据病理类型分组,比较各组代谢参数的差异、各参数与肿瘤标志物的相关性以及不同分期中各指标的差异。结果鳞癌患者SUVmax、MTV、TLG均显著高于腺癌,差异有统计学意义(P<0.01)。小细胞肺癌(SCLC)患者TLG显著高于腺癌,差异有统计学意义(P<0.05)。鳞癌、腺癌及SCLC患者原发灶直径、腺癌与SCLC患者SUVmax/MTV、鳞癌与SCLC患者代谢参数比较,差异均无统计学意义(P>0.05)。腺癌患者原发灶直径、MTV、TLG与血清CEA(r=0.449、0.452、0.422,P<0.01)、CYFRA21-1水平(r=0.472、0.448、0.449,P<0.01)均呈中等正相关;鳞癌患者原发灶直径、MTV与CYFRA21-1间(r=0.573、0.700,P<0.01),TLG与SCCA、CYFRA21-1间(r=0.504、0.544,P<0.01)亦呈中等正相关;SCLC患者各项代谢参数与肿瘤标志物无相关性(P>0.05)。与鳞癌和SCLC不同,腺癌患者Ⅰa~Ⅲa期与Ⅲb~Ⅳb期原发灶直径、MTV、TLG、CEA及CYFRA21-1差异均有统计学意义(P<0.05)。结论肺癌原发灶的代谢特征与肿瘤标志物的关系及其危险性因病理类型的差异而不同。腺癌与鳞癌的非SUVmax代谢参数直径、MTV、TLG与血清肿瘤标志物具有一定的相关性。腺癌的非SUVmax代谢参数及血清CEA、CYFRA21-1水平是影响分期的危险因素。Purpose To analyze the relationship between 18 F-FDG PET/CT metabolic parameters of primary lung cancer and serum tumor markers,and to analyze the differences between the two in stageⅠa-Ⅲa and stageⅢb-Ⅳb lung cancer.Materials and Methods Ninety-seven patients with newly diagnosed lung cancer underwent 18 F-FDG PET/CT examination were retrospectively analyzed,the diameter of the primary lesion,maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were measured,the lung cancer serum markers carcinoembryonic antigen(CEA),cytokeratin-19 fragment antigen(CYFRA21-1),neuron-specific enolase(NSE),squamous cell carcinoma antigen(SCCA)and pro-gastrin-releasing peptide(Pro-GRP)were detected.Based on the results of PET/CT staging,TNM staging was performed based on comprehensive patient clinical data.Metabolic parameters of different histopathologic lung cancer were compared.Correlation of parameters with tumor markers were analyzed,and their differences between stages were assessed.Results SUVmax,MTV and TLG of squamous cell carcinoma were significantly higher than those of adenocarcinoma(P<0.01).The TLG of patients with small cell lung cancer(SCLC)was significantly higher than that of adenocarcinoma(P<0.05).No significant differences were found in diameter of three subtypes,in SUVmax and MTV between adenocarcinoma and SCLC,also in metabolic parameters between squamous cell carcinoma and SCLC(P>0.05).The primary tumor diameter,MTV,TLG and serum CEA(r=0.449,0.452,0.422,P<0.01),CYFRA21-1 level(r=0.472,0.448,0.449,P<0.01)were all moderately correlated;primary squamous cell carcinoma diameter,MTV and CYFRA21-1(r=0.573,0.700,P<0.01),TLG and SCCA,CYFRA21-1(r=0.504,0.544,P<0.01)were also moderately positive related;there was no correlation between metabolic parameters of SCLC patients and tumor markers(P>0.05).Different from squamous cell carcinoma and SCLC,the differences in primary tumor diameters,MTV,TLG,CEA and CYFRA21-1 in stagesⅠa-Ⅲa andⅢb-Ⅳb of adenocarcinoma pat

关 键 词：肺肿瘤 正电子发射断层显像计算机体层摄影术 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 癌胚抗原 角蛋白质类 抗原 肿瘤 磷酸丙酮酸水合酶 胃泌素释放肽 病理学 外科 

分 类 号：R734.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]