肝样腺癌的^18F-FDG PET/CT及病理特征分析  

Analysis on the ^18F-FDG PET/CT and pathological features of HAC

作　　者：梁子威 李培杰 赵葵[1] 王国林[1] 王华涛[1] 颜晶 诸欢颜 LIANG Zi-wei;LI Pei-jie;ZHAO Kui(The Center of PET/CT,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院PET/CT中心,浙江杭州310003 [2]浙江大学医学院附属第一医院病理科,浙江杭州310003

出　　处：《中国医学装备》2020年第12期52-55,共4页China Medical Equipment

摘　　要：目的:探讨肝样腺癌(HAC)的18F-脱氧葡萄糖(18F-FDG)PET/CT表现,分析其影像学特征。方法:收集在医院就诊的8例确诊肝样腺癌并于术前行18F-FDGPET/CT检查的患者资料,记录患者的临床资料、血清甲胎蛋白(APF)、病灶位置、最大标准化摄取值(SUVmax)及病理组织形态学,并复习相关文献。分析病灶生物学行为和18F-FDG代谢特征。结果:在8例HAS患者中,症状伴有腹痛4例,伴有胸痛2例,无症状1例;血清AFP中7例患者AFP升高41.9~5330.2 ng/ml,其中3例>500 ng/ml,仅有1例患者的血清AFP在正常范围(5.9 ng/ml);病灶位置中5例位于胃,2例位于肺内,1例位于直肠;8例患者SUVmax为25.2,最小值为4.3,平均值为12.5;肿瘤由肝样分化区伴或不伴普通腺癌区组成,部分为混合性腺癌。免疫表型中肝样分化区磷脂酰肌醇蛋白多糖-3(Glypican-3,GPC-3)、AFP和Hepatocyte肝细胞标志物呈不同程度阳性。结论:HAC是特殊类型腺癌,组织学形态及免疫表型与肝细胞肝癌(HCC)相似,病灶部位以胃为主,位于肺、肝脏及结直肠等,血清AFP升高是肝样腺癌诊断的重要参考指标,18F-FDG PET/CT检查SUVmax显著高于普通胃腺癌及印戒细胞癌。Objective:To investigate the performance of positron emission tomography/computed tomography(PET/CT)of hepatoid adenocarcinoma(HAC)and analyze the relevant imaging characteristics.Methods:The data of 8 patients with confirmed HAC who admitted to hospital and underwent preoperative PET/CT examination were collected retrospectively.The clinical data,serum alpha fetoprotein(APF),lesion location,maximum standard uptake value(SUVmax)and pathological histomorphology of the patients were recorded,and the relevant literature was reviewed.The biological behavior of lesion and 18F-deoxyglucose(FDG)metabolic characteristicsm were further analyzed.Results:In 8 HAS patients,four patients had abdominal pain,two had chest pain,and one had no symptoms.The serum AFP levels of 7 patients increased within 41.9 ng/mL and 5330.2 ng/mL,and 3 patients among of them were over 500 ng/mL,and only that of 1 patient was within normal range(5.9 ng/mL).Five cases located in the stomach,and two cases located in the lung,and 1 case located in the rectum.The SUVmax of 8 patients was 25.2,and the minimum value of them was 4.3 and the average value of them was 12.5.The neoplasm consisted of hepatic differentiation region with or without general adenocarcinoma,and some of which were mixed adenocarcinoma.In immunophenotype:Glypican-3(GPC-3),AFP,and hepatocyte biomarker of hepatic differentiation region showed different degrees of positivity.Conclusion:HAC is a special type of adenocarcinoma,which is similar to HCC in histological morphology and immunophenotype.Known lesions mainly located in the stomach,but also locate in the lung,liver,colorectal,etc.The increased serum AFP is an important reference indicator in diagnosing hepatoid adenocarcinoma.And the SUVmax of 18F-FDG PET/CT examination is significantly higher than that of ordinary gastric adenocarcinoma and signet ring cell carcinoma.

关 键 词：肝样腺癌(HAC) 正电子发射断层扫描/CT(PET/CT) 甲胎蛋白(AFP) 临床病理 免疫组化 

分 类 号：R817.8[医药卫生—影像医学与核医学]