肝泡型棘球蚴病病灶微环境摄取氟代脱氧葡萄糖的特征研究  

Study on the characteristics of ^(18)F-flurodeoxyglucose uptake in the microenvironment of hepatic alveolar echinococcosis

作　　者：阿卜杜艾尼·啊卜力孜 阿卜杜萨拉木·艾尼 冉博[1] 蒋铁民[1] 张瑞青[1] 郭强[1] 李肖红[3] 王健[4] 张传山 林仁勇[5] 温浩[6] 邵英梅 吐尔干艾力·阿吉[1] 排组拉沙拉依阿当 Abuduaini Abulizi;Abudusalamu Aini;Ran Bo;Jiang Tiemin;Zhang Ruiqing;Guo Qiang;Li Xiaohong;Wang Jian;Zhang Chuanshan;Lin Renyong;Wen Hao;Shao Yingmei;Tuerganaili Aji;Paizulashalayiadang(State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,Department of Hepatobiliary and Echinococcosis Surgery,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Hepatopancreatobiliary Center,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China;Department of Nuclear Medicine,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Medical Imaging Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Clinical Medical Research Institute,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;State Key Laboratory of Pathogenesis,Prevention and Treatment of High Incidence Diseases in Central Asia,Xinjiang Medical University,Urumqi 830011,China;Digestive and Vascular Surgery Center,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]省部共建中亚高发病成因与防治国家重点实验室、新疆医科大学第一附属医院肝胆包虫病外科,乌鲁木齐830054 [2]清华大学附属北京清华长庚医院肝胆胰中心,北京102218 [3]新疆医科大学第一附属医院核医学科,乌鲁木齐830054 [4]新疆医科大学第一附属医院医学影像中心,乌鲁木齐830054 [5]新疆医科大学临床医学研究院,乌鲁木齐830054 [6]新疆医科大学省部共建中亚高发病成因与防治国家重点实验室,乌鲁木齐830011 [7]新疆医科大学第一附属医院消化血管外科中心,乌鲁木齐830054

出　　处：《中华肝胆外科杂志》2023年第3期176-180,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：新疆维吾尔自治区自然科学基金(2021D01C298);省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2020-24、SKL-HIDCA-2019-23)。

摘　　要：目的:研究肝泡型棘球蚴病病灶微环境在正电子发射计算机断层显像(PET/CT)中摄取氟代脱氧葡萄糖(^(18)F-FDG)的特征。方法:采用前瞻性研究方法,收集2017年1月至2019年12月在新疆医科大学第一附属医院治疗并行PET/CT检查的39例肝泡型棘球蚴病患者临床资料,其中男性17例,女性22例,中位年龄34岁,年龄范围15-65岁。根据CT所示的钙化和液化程度将患者病灶分6组:A-无钙化+无液化(n=7);B-明显钙化+无液化(n=7);C-部分钙化+部分液化(n=10);D-明显钙化+部分液化(n=5);E-部分钙化+近全液化(n=5);F-明显钙化+近全液化(n=5)。基于PET/CT测量病灶微环境摄取比值(TBR)及宽度W值,应用Mann-Whitney检验对各组进行比较。进行相关分析。结果:A-F各组TBR值依次为[M(Q_(1),Q_(3))]4.40(3.66,7.03)、2.55(1.69,3.60)、3.73(3.37,5.21)、2.90(2.75,3.60)、3.80(3.49,6.36)、2.49(2.21,3.97),其中A>B、A>D、A>F、C>B、E>B(U=3.0、4.0、4.5、11.0、5.0,P<0.05),从各组病灶的钙化程度的角度分析发现钙化越轻,TBR值越大。A-F各组的W值依次为[M(Q1,Q3)]12.5(10.0,19.5)、11.2(10.5,12.5)、12.2(10.9,13.2)、7.8(7.3,9.3)、10.0(7.3,13.4)、7.3(6.8,7.6)mm,其中A>D、A>F、B>D、B>F、C>D、C>F(U均为0,均P<0.05)。从各组病灶的钙化和液化程度的角度分析发现,钙化越轻,W值越大;液化越重,W值越小。TBR值与W值呈线性相关关系(r=0.4136,P<0.05)。结论:可根据基于^(18)F-FDG摄取的不同肝泡型棘球蚴病灶类型进行个体化选择根治性手术切缘和取材。Objective To investigate characteristics of the ^(18)F-flurodeoxyglucose(^(18)F-FDG)uptake intensity and ranges in distinct hepatic alveolar echinococcosis lesions.Methods The clinical data of 39 patients with position emission tomography during Jan 2017 to Dec 2019 in the First Affiliated Hospital of Xinjiang Medical University were enrolled.Among them,there were 17 males and 22 females,aging from 15 to 65 years(median 34 years).Lesions were classified into six groups based on heterogenic scales of calcification and liquefaction:A.non-calcified and non-liquefied(n=7);B.obvious calcified and non-liquefied(n=7);C.partial calcified and partial liquefied(n=10);D.obvious calcified and partial liquefied(n=5);E.partial calcified and subtotal liquefied(n=5);F.obvious calcified and subtotal liquefied(n=5).Tumor to background ratio(TBR)and width(W)of lesion infiltrative boundary were measured and calculated.Statistical comparison using Mann-Whitney U test as well as correlation analysis was performed.Results TBR values[M(Q_(1),Q_(3))]for each group were 4.40(3.66,7.03),2.55(1.69,3.60),3.73(3.37,5.21),2.90(2.75,3.60),3.80(3.49,6.36),2.49(2.21,3.97),among which A>B,A>D,A>F,C>B,E>B(U=3.0,4.0,4.5,11.0,5.0,all P<0.05);From the perspective of the calcification in each group,it was found that the lighter the calcification was,the greater the TBR value was.W values[M(Q1,Q3)]for each group were[12.5(10.0,19.5),11.2(10.5,12.5),12.2(10.9,13.2),7.8(7.3,9.3),10.0(7.3,13.4),7.3(6.8,7.6)]mm,among which A>D,A>F,B>D,B>F,C>D,C>F(all U=0,all P<0.05);According to the degree of calcification and liquefaction of lesions in each group,the lighter the calcification was,the greater the W value was;The heavier the liquefaction was,the smaller the W value was.A mild strength linear correlation has been observed between the TBR value and W value(r=0.4136,P<0.05).Conclusions Less calcification and liquefaction implicated higher ^(18)F-FDG uptake intensity and wider range.Radical resection margins and tissue sampling should be individualized based on

关 键 词：棘球蚴病 肝 病灶微环境 氟代脱氧葡萄糖 正电子发射计算机断层显像 手术 组织取材 

分 类 号：R532.32[医药卫生—内科学]