^(18)F-FDG PET/CT在乳腺癌患者孤立性肺内病变鉴别诊断中的应用  

Application of^(18)Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography to Predict Solitary Pulmonary Lesions in Breast Cancer Patients

作　　者：薛杨央[1] 汪会[1] 余文静 张丹[1] 许阿磊 徐慧琴[1] XUE Yang-yang;WANG Hui;YU Wen-jing;ZHANG Dan;XU A-lei;XU Hui-qin(Department of Nuclear Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui Province,China)

机构地区：[1]安徽医科大学第一附属医院核医学科,安徽合肥230022

出　　处：《中国CT和MRI杂志》2022年第8期90-95,共6页Chinese Journal of CT and MRI

基　　金：国家自然科学基金面上项目(81971643)。

摘　　要：目的探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)联合临床病理学特征对乳腺癌患者孤立性肺结节(SPN)的鉴别诊断价值。方法将80例新检出SPN的乳腺癌患者分为原发性肺癌组(PLC,n=48)和乳腺癌转移组(BCM,n=32)。回顾性分析两组患者的临床、病理和PET/CT图像特征,对两组间临床病理特征、PET/CT代谢参数和形态学特征进行差异比较,并使用多因素分析探讨SPN诊断的独立预测因素。结果临床病理学指标中,PLC组和BCM组的血清CEA和CA15-3水平存在显著性差异(CEA:P=0.045,CA15-3:P=0.008)。^(18)F-FDG PET/CT代谢特征中,PLC组与BCM组图像FDG摄取、SPN的SUV_(max)、肺门和/或纵隔淋巴结转移、肺门和/或纵隔淋巴结的SUV_(max)等代谢参数差异有统计学意义(P=0.016,P<0.001,P=0.01和P=0.032)。形态学分析中,分叶征(P<0.001)、毛刺征(P<0.001)和胸膜牵拉征(P=0.014)等PLC的典型特征是鉴别PLC与BCM的主要征象。其中SPN的SUV_(max)、分叶征和胸膜凹陷征是准确诊断SPN的预测因素。结论^(18)F-FDG PET/CT结合临床病理特征对乳腺癌患者SPN的诊断具有重要价值,SPN的SUV_(max)、分叶征和胸膜凹陷征在SPN鉴别诊断中的作用最大。Objective To investigate the value of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)combined with clinicopathological predictors for the differential diagnosis of solitary pulmonary nodule(SPN)in breast cancer patients.Methods Eighty breast cancer patients with new detected SPN were enrolled in the study and devided into primary lung cancer group(PLC,n=48)and breast cancer metastasis group(BCM,n=32).The clinicopathological characteristics,metabolic and morphological characteristics on^(18)F-FDG PET/CT images of 80 patients were retrospectively reviewed.The differences of clinicopathological and ^(18)F-FDG PET/CT characteristics between the two groups were analyzed,and multivariate analyses for the diagnosis of SPN were performed.Results Clinicopathological terms of serum CEA and CA15-3 level exhibited significant differences between PLC group and BCM group(P=0.045 and P=0.008,respectively).Metabolic characteristics of^(18)F-FDG PET/CT images including FDG uptake,SUV_(max) of SPN,hilar and/or mediastinal lymph node metastasis,SUV_(max) of hilar and/or mediastinal lymph node showed significant differences between PLC group and BCM group(P=0.016,P<0.001,P=0.01 and P=0.032,respectively).The lobulation sign(P<0.001),spicule sign(P<0.001)and pleural indentation sign(P=0.014)were statistically morphological features of PLC in^(18)F-FDG PET/CT images.Among them,SUV_(max) of SPN,lobulation sign and pleural indentation sign were valuable predictive factors for accurate diagnoses of SPN in breast cancer patients.Conclusion^(18)F-FDG PET/CT combined with clinicopathological characteristics are valuable for the diagnosis of SPN in breast cancer patients.

关 键 词：孤立性肺结节 转移瘤 乳腺癌 原发性肺癌 ^(18)F-FDG PET/CT 

分 类 号：R445.3[医药卫生—影像医学与核医学] R445.6[医药卫生—诊断学] R817.4[医药卫生—临床医学]