肺神经内分泌肿瘤的临床病理特征及^(18)F-FDG PET/CT影像表现分析  

Analysis of the clinicopathological characteristics and ^(18)F-FDG PET/CT imaging features of bronchopulmonary neuroendocrine tumors

作　　者：汤敏敏 尤阳 李夏黎 武新宇 轩昂 高永举 徐俊玲 Tang Minmin;You Yang;Li Xiali;Wu Xinyu;Xuan Ang;Gao Yongju;Xu Junling(Department of Nuclear Medicine,People′s Hospital of Zhengzhou University,Henan Provincial People′s Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院、河南省人民医院核医学科,450003

出　　处：《中华核医学与分子影像杂志》2021年第5期262-267,共6页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家临床重点专科建设项目(2013-544)。

摘　　要：目的探讨不同病理亚型肺神经内分泌肿瘤(BP-NETs)的临床病理特征及^(18)F-脱氧葡萄糖(FDG)PET/CT影像表现的差异。方法回顾性分析2013年1月至2018年5月间在河南省人民医院经病理学确诊的280例BP-NETs患者(男196例,女84例,中位年龄58岁)的临床病理资料及PET/CT显像结果。从年龄、性别、有无吸烟史、肿瘤位置、肿瘤大小、细胞增殖核抗原Ki-67阳性指数、甲状腺转录因子-1(TTF-1)、突触素(Syn)、嗜铬素A(CgA)、CD56、^(18)F-FDG摄取、淋巴结转移、远处转移等方面比较典型类癌(TC)、不典型类癌(AC)、小细胞肺癌(SCLC)和大细胞神经内分泌癌(LCNEC)患者的差异。采用单因素方差分析、χ^(2)检验、Fisher确切概率法和Kruskal-Wallis秩和检验分析数据。结果TC(59例)、AC(21例)、SCLC(184例)和LCNEC(16例)4组患者的年龄、吸烟史、肿瘤大小及位置、细胞增殖核抗原Ki-67阳性指数、CgA、CD56、TTF-1、最大标准摄取值(SUV_(max))、TNM分期的差异有统计学意义(F值:2.067、3.358,H值:17.749~22.351,均P<0.05)。SCLC组肿瘤最大[5.5(3.0,6.8)cm],中央型所占比例最高(85.3%,157/184),更易出现淋巴结转移;LCNEC组年龄最大[(66±16)岁],有吸烟史者最多(14/16),周围型所占比例最高(12/16)。SCLC组(95.7%,176/184)与LCNEC组(15/16)的CD56多呈阳性表达,TC组和AC组的CgA、TTF-1阳性表达率高[96.6%(57/59)、93.2%(55/59)和95.2%(20/21)、90.5%(19/21)]。4组患者的细胞增殖核抗原Ki-67阳性指数及SUV_(max)均为SCLC组最高,TC组最低。结论不同病理亚型的BP-NETs患者的临床病理特征及^(18)F-FDG PET/CT影像表现存在一定差异,分析这些差异可能有助于更好地认识各种亚型不同的特性。Objective To investigate the clinicopathological characteristics and ^(18)F-fluorodeoxyglucose(FDG)PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs)with different pathological subtypes.Methods From January 2013 to May 2018,280 patients(196 males,84 females,median age 58 years)with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed.Age,gender,smoking history,the location and size of tumor,Ki-67 positive index,thyroid transcription factor-1(TTF-1),synaptophysin(Syn),chromogranin-A(CgA),CD56,maximum standardized uptake value(SUV_(max)),lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs,including typical carcinoid(TC),atypical carcinoid(AC),small cell lung carcinoma(SCLC)and large cell neuroendocrine carcinoma(LCNEC).One-way analysis of variance,χ^(2) test,Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis.Results There were significant differences in age,smoking history,tumor size and location,Ki-67 positive index,CgA,CD56,TTF-1,SUV_(max) and TNM stage among TC(n=59),AC(n=21),SCLC(n=184)and LCNEC(n=16)groups(F values:2.067,3.358,H values:17.749-22.351,all P<0.05).SCLC had the largest tumor size(5.5(3.0,6.8)cm)and the highest proportion of central type(85.3%,157/184),and were more prone to lymph node metastasis.LCNEC had the oldest age((66±16)years),the largest proportion of smoking history(14/16)and peripheral type(12/16).CD56 in SCLC(95.7%,176/184)and LCNEC(15/16)mostly showed positive expression,while the positive expression rates of CgA and TTF-1 were higher in TC and AC(96.6%(57/59),93.2%(55/59)and 95.2%(20/21),90.5%(19/21),respectively).The Ki-67 positive index and SUV_(max) of the four subtypes were significantly different,with the highest in SCLC group and the lowest in TC group.Conclusion Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on ^(18)F-FDG PET/CT,which are useful for understanding th

关 键 词：癌 神经内分泌 肺 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R734.2[医药卫生—肿瘤]