乳腺癌术后第二原发卵巢癌的^(18)F-FDG PET/CT表现及临床分析  

^(18)F-FDG PET/CT findings and clinical analysis of the second primary ovarian cancer after breast cancer surgery

作　　者：张静[1] 房娜[1] 王清[1] 林帅 王艳丽[1] ZHANG Jing;FANG Na;WANG Qing;LIN Shuai;WANG Yanli(Department of Molecular Imaging,the Affiliated Qingdao Central Hospital of Qingdao University,Qingdao,Shandong Province 266042,China)

机构地区：[1]青岛大学附属青岛市中心医院分子影像科,山东青岛266042

出　　处：《实用放射学杂志》2023年第10期1647-1651,共5页Journal of Practical Radiology

摘　　要：目的探讨乳腺癌术后第二原发卵巢癌的18氟脱氧葡萄糖正电子发射断层显像/计算机体层成像(^(18)F-FDG PET/CT)表现及临床特征。方法回顾性分析行^(18)F-FDG PET/CT检查的696例乳腺癌术后6个月以上患者的临床影像资料,将最终确诊为第二原发卵巢癌的12例(1.7%)患者纳入研究,分析^(18)F-FDG PET/CT表现及临床特征。结果12例患者,16个卵巢病变均伴^(18)F-FDG代谢增高;13个病变为囊实性、2个病变为实性、1个卵巢无明显形态学异常;位于双侧附件区4例、左侧附件区5例、右侧附件区3例;平均径线为12.0~57.0 mm,最大标准化摄取值(SUVmax)为3.3~12.4,最大瘦体质量标准化摄取值(SULmax)为2.1~8.4。12例均有腹膜转移及腹水;腹膜呈“污垢样”4例、结节样7例、“网膜饼”1例,SUVmax为3.2~15.6,SULmax为2.2~11.4;少至中量腹水8例、大量腹水4例,SUVmax为2.3~3.9,SULmax为1.5~2.8。6例有淋巴结转移,SUVmax为3.7~11.0,SULmax为2.5~7.9。主要临床表现为腹胀和腹痛。糖类抗原125(CA125)水平为260.3~4390.0 U/mL,人附睾蛋白4(HE4)水平为172.1~1500.0 pmol/L,阳性率均为100.0%。卵巢病变的SUVmax和SULmax分别与腹膜转移的SUVmax和SULmax呈正相关(r_(1)=0.81,r_(2)=0.71,P<0.05),与CA125水平呈负相关(r_(1)=-0.71,r_(2)=-0.88,P<0.05)。结论在乳腺癌术后患者中,^(18)F-FDG PET/CT显示附件区囊实性病变伴^(18)F-FDG代谢增高,或附件无明显形态学异常但伴有^(18)F-FDG代谢增高,结合肿瘤标志物CA125和HE4水平升高,要考虑第二原发卵巢癌的可能。Objective To investigate 18 fluorodeoxyglucose-positron emission tomography/computed tomography(^(18)F-FDG PET/CT)findings and clinical features of the second primary ovarian cancer after breast cancer surgery.Methods A total of 696 patients who underwent^(18)F-FDG PET/CT more than 6 months after breast cancer surgery were analyzed retrospectively.12 patients(1.7%)with final diagnosis of second primary ovarian cancer were enrolled to analyze the^(18)F-FDG PET/CT findings and clinical features.Results In 12 patients,all 16 ovarian lesions were associated with increased metabolism of^(18)F-FDG;13 lesions were cystic-solid,2 lesions were solid and one ovary showed no obviously morphological abnormality;it is located in the bilateral adnexal region in 4 cases,the left adnexal region in 5 cases,and the right adnexal region in 3 cases;the mean diameter was 12.0-57.0 mm,the maximum standardized uptake value(SUVmax)was 3.3-12.4,and the maximum standardized uptake value by lean body mass(SULmax)was 2.1-8.4.All 12 cases had peritoneal metastasis and ascites;the peritoneum was“dirt-like”in 4 cases,nodular in 7 cases and“omental cake”in 1 case,SUVmax was 3.2-15.6,SULmax was 2.2-11.4;few-middle amount of ascites in 8 cases and large amount of ascites in 4 cases,SUVmax was 2.3-3.9,SULmax was 1.5-2.8.6 cases had lymph nodes metastases,SUVmax was 3.7-11.0,SULmax was 2.5-7.9.The main clinical manifestations were abdominal distension and pain.The level of carbohydrate antigen 125(CA125)was 260.3-4390.0 U/mL and the level of human epididymal protein 4(HE4)was 172.1-1500.0 pmol/L,the positive rates were 100.0%for both.The SUVmax and SULmax of ovarian lesions were positively correlated with SUVmax and SULmax of peritoneal metastases(r_(1)=0.81,r^(2)=0.71,both P<0.05),and negatively correlated with and the level of CA125(r_(1)=-0.71,r_(2)=-0.88,both P<0.05),respectively.Conclusion Among postoperative breast cancer patients,^(18)F-FDG PET/CT show cystic-solid lesions in the adnexal region with increased metabolism of^(18)F-FDG,

关 键 词：乳腺癌 卵巢癌 双源癌 正电子发射断层显像/计算机体层成像 临床特征 

分 类 号：R737.9[医药卫生—肿瘤] R737.31[医药卫生—临床医学] R814.42