肾透明细胞癌^(18)F-FDG PET/CT代谢参数及代谢异质性与WHO/ISUP病理分级的相关性研究  

Correlation between metabolic parameters and metabolic heterogeneity of ^(18)F-FDG PET/CT in renal clear cell carcinoma and WHO/ISUP pathological grading

作　　者：廖凤翔[1] 张文燕 李晓芬[3] 漆婉玲 刘谦[4] 曾庆云 朱心燊[5] 张颖 沈庆林 LIAO Fengxiang;ZHANG Wenyan;LI Xiaofen;QI Wanling;LIU Qian;ZENG Qingyun;ZHU Xinshen;ZHANG Ying;SHEN Qinglin(Jiangci Provincial People's Hospital,First Affiliated Hospital of Nanchang Medical College,Nanchang 330006,China)

机构地区：[1]江西省人民医院.南昌医学院第一附属医院核医学科,江西南昌330006 [2]江西省人民医院.南昌医学院第一附属医院医保科,江西南昌330006 [3]江西省人民医院.南昌医学院第一附属医院影像科,江西南昌330006 [4]江西省人民医院.南昌医学院第一附属医院病理科,江西南昌330006 [5]江西省人民医院.南昌医学院第一附属医院泌尿外科,江西南昌330006 [6]江西省人民医院.南昌医学院第一附属医院肿瘤科,江西南昌330006

出　　处：《中华肿瘤防治杂志》2023年第12期753-757,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：江西省卫生健康委科技计划项目(202310166)。

摘　　要：目的 探讨肾透明细胞癌(ccRCC)^(18)F-氟脱氧葡萄糖(^(18)F-FDG)PET/CT代谢参数及代谢异质性与世界卫生组织/国际泌尿病理学会(WHO/ISUP)病理分级的相关性。方法 回顾性分析江西省人民医院2016-01-08-2019-12-26经病理学确诊的36例ccRCC患者^(18)F-FDG PET/CT影像及临床资料,测量ccRCC原发病灶最大标准摄取值(SUV_(max))、肿瘤代谢体积(MTV)和糖酵解率总量(TLG),计算变异系数(COV)。通过两独立样本检验或Mann-Whitney U检验比较不同T分期、分化程度及转移情况各组间代谢参数SUV_(max)、MTV、TLG和COV的差异;采用Spearman相关性分析^(18)F-FDG PET/CT代谢参数与ccRCC WHO/ISUP病理分级的关系。结果 36例ccRCC患者中,WHO/ISUP病理分级1级4例,2级19例,3级8例,4级5例。SUV_(max)平均值为6.9±6.3(1.1~27.1),MTV为(3.2±7.9) cm^(3)(4.8~26.1 cm^(3)),TLG为(46.8±25.3) g(6.9~146.6 g)、COV为25.7±13.2(6.3~51.8)。ccRCC原发病灶T3-4组的SUV_(max)、MTV、TLG和COV均大于T1-2组,MTV(Z=-2.382,P=0.034)、TLG(Z=-2.486,P=0.032)和COV(Z=-2.127,P=0.041)差异有统计学意义,SUV_(max)(Z=-1.131,P=0.191)差异无统计学意义;ccRCC原发病灶合并转移组、低分化组的SUV_(max)(Z=-2.569,P=0.010;Z=-4.499,P<0.001)、MTV(Z=-1.732,P=0.042;Z=-2.418,P=0.013)、TLG(Z=-1.814,P=0.035;Z=-2.235,P=0.025)、COV(Z=-1.785,P=0.048;Z=-2.018,P=0.037)分别高于无转移组和高分化组,且差异均有统计学意义。ccRCC原发病灶SUV_(max)、MTV、TLG、COV与肿瘤T分期无显著相关性,与N分期呈中度正相关,与WHO/ISUP病理分级呈中度负相关。结论 ccRCC原发病灶^(18)F-FDG PET/CT代谢参数SUV_(max)、MTV、TLG及COV与WHO/ISUP病理分级有一定相关性。Objective To investigate the correlation between the metabolic parameters and metabolic heterogeneity of ^(18)F-FDG PET/CT in clear cell renal cell carcinoma(ccRCC)and the World Health Organization/International Society of Urological Pathology(WHO/ISUP)pathological grade of ccRCC.Methods The ^(18)F-FDG PET/CT images and clinical data of 36 patients with ccRCC confirmed by pathology in Jiangxi Provincial People's Hospital from January 8,2016 to December 26,2019 were retrospectively analyzed.The maximum standard intake value(SUV_(max)),tumor metabolic volume(MTV)and total glycolysis rate(TLG)of primary lesions of ccRCC were measured before surgery,then the coefficient of variation(COV)was calculated.Two independent sample test or Mann-Whitney U test were used to compare the differences of metabolic parameters SUV_(max),MTV,TLG and COV among different groups at different T stages,degrees of differentiation and metastasis.Spearman correlation was used to analyze the relationship between metabolic parameters of ^(18)F-FDG PET/CT and pathological grading of ccRCC WHO/ISUP.Results Among the WHO/ISUP pathological grades of36ccRCC patients,4cases were grade 1,19 cases were grade 2,8 cases were grade 3 and 5 cases were grade 4.The average values of SUV_(max),MTV,TLG and COV were respectively 6.9±6.3 (1.1-27.1),(3.2±7.9)cm^(3)(4.8-26.1cm^(3)),(46.8±25.3)g(6.9-146.6g),25.7±13.2(6.3-51.8).The SUV_(max),MTV,TLG and COV of the primary ccRCC lesion in T_(3-4)group were higher than the corresponding values in T_(1-2)group,with statistically significant differences in MTV(Z=-2.382,P=0.034),TLG (Z=-2.486,P=0.032)and COV (Z=-2.127,P=0.041),but no statistically significant differences were observed in SUV_(max)(Z=-1.131,P=0.191).The SUV_(max)(Z=-2.569,P=0.010;Z=-4.499,P<0.001),MTV (Z=-1.732,P=0.042;Z=-2.418,P=0.013),TLG (Z=-1.814,P=0.035;Z=-2.235,P=0.025),COV (Z=-1.785,P=0.048;Z=-2.018,P=0.037)of the primary ccRCC lesion combined with metastasis and the poorly differentiated group were higher than those of the non-metastatic grou

关 键 词：肾透明细胞癌 异质性 代谢参数 病理分级 相关性 

分 类 号：R737.11[医药卫生—肿瘤]