胸腺淋巴瘤18F-FDG PET/CT代谢参数与临床分期及病理分型的相关性研究  

Correlation of 18F-FDG PET/CT metabolic parameters with clinical staging and pathological classification in thymic lymphoma

作　　者：潘越 杜磊[2] 翟雪[1] 王观筠 徐晓丹 孟晓琳[1,2] 刘家金 王瑞民[2] 徐白萱[2] PAN Yue;DU Lei;ZHAI Xue;WANG Guanyun;XU Xiaodan;MENG Xiaolin;LIU Jiajin;WANG Ruimin;XU Baixuan(Chinese PLA Medical School,Beijing 100853,China;Department of Nuclear Medicine,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第一医学中心核医学科,北京100853

出　　处：《解放军医学院学报》2023年第9期973-978,共6页Academic Journal of Chinese PLA Medical School

摘　　要：背景18F-FDG PET/CT利用图像融合技术,可显示功能代谢异常及结构的改变,但其在胸腺淋巴瘤鉴别诊断、分期和分型中的作用研究仍相对较少。目的探讨胸腺淋巴瘤的18F-FDG PET/CT代谢参数与其病理分型及临床分期的关系。方法选取2015年1月-2022年5月于解放军总医院一中心核医学科行PET/CT检查和病理学证实为胸腺淋巴瘤的患者,记录胸腺淋巴瘤病灶最大标准摄取值(maximum standard uptake value,SUVmax)、平均标准摄取值(mean standard uptake value,SUVmean)、代谢体积(metabolic tumor volume,MTV)、病灶糖酵解总量(total lesion glycolysis,TLG)和肿瘤-正常肝组织标准摄取值比值(tumor-to-normal liver standard uptake value ratio,SUVR)。以淋巴结和结外器官受累结果进行Ann Arbor分期,并根据主要病理类型进行分组。对18F-FDG PET/CT代谢参数与临床病理分型、分期的相关性进行分析。结果共计85例患者纳入研究,男性46例、女性39例,年龄(30.34±14.48)岁。其中原发性纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma,PMBCL)35例,结节硬化型霍奇金淋巴瘤(nodular sclerosis Hodgkin lymphoma,NSHL)29例,T淋巴母细胞淋巴瘤(T-cell lymphoblastic lymphoma,T-LBL)19例。Ann Arbor分期:Ⅰ期2例,Ⅱ期29例,Ⅲ期10例,Ⅳ期44例。PMBCL、NSHL、T-LBL三组间各项代谢参数的差异均有统计学意义(P<0.05)。不同Ann Arbor分期间各代谢参数差异均有统计学意义(P<0.05)。胸腺淋巴瘤Ann Arbor分期与各项代谢参数均呈正相关(TLG:rs=0.494,P<0.01;MTV:rs=0.469,P<0.01;SUVR:rs=0.378,P<0.01;SUVmax:rs=0.296,P=0.006;SUVmean:rs=0.273,P=0.012)。结论不同病理类型胸腺淋巴瘤的18F-FDG PET/CT代谢参数存在一定差异,代谢参数TLG、MTV、SUVR与胸腺淋巴瘤Ann Arbor分期中度相关,可为临床制定治疗计划提供参考。Background 18F-FDG PET/CT can display abnormal functional metabolism and structural changes by using image fusion technology,but there are still relatively few studies on differential diagnosis,staging and classification of thymic lymphoma.Objective To investigate the relationship between 18F-FDG PET/CT metabolic parameters of thymic lymphoma and its pathological staging and typing.Methods Patients who underwent PET/CT at the Department of Nuclear Medicine,Chinese PLA General Hospital from January 2015 to May 2022 and were diagnosed with thymic lymphoma on pathology were selected for the study.The maximum standard uptake values(SUVmax),mean standard uptake values(SUVmean),metabolic tumor volume(MTV),total lesion glycolysis(TLG)and tumor-to-normal liver standard uptake value ratio(SUVR)were recorded.Ann Arbor staging was performed based on state of lymph nodes and extra lymph nodes,and the main pathological types were classified.Spearman correlation analysis was made between metabolic parameters of 18F-FDG PET/CT and Ann Arbor stage.Results A total of 85 patients(46 males and 39 females,aged[30.34-14.48]years)were enrolled in the study,including 35 cases of primary mediastinal large B-cell lymphoma(PMBcl),29 cases of nodular sclerosis Hodgkin lymphoma(NSHL)and 19 cases of T-lymphoblastic lymphoma.There were 2,29,10 and 44 patients in Ann Arbor stagesⅠ,Ⅱ,ⅢandⅣ,respectively.The differences of metabolic parameters between PMBCL,NSHL and T-LBL were statistically significant(P<0.05).The differences of metabolic parameters in different Ann Arbor periods were also statistically significant(P<0.05).Ann Arbor stage was positively correlated with various metabolic parameters,including TLG(rs=0.494,P<0.01),MTV(rs=0.469,P<0.01),SUVR(rs=0.378,P<0.01),SUVmax(rs=0.296,P=0.006),and SUVmean(rs=0.273,P=0.012).Conclusion There are certain differences in 18F-FDG PET/CT metabolic parameters among different pathologic types of thymic lymphomas.The metabolic parameters TLG,MTV,and SUVR are moderately correlated with the Ann Arbo

关 键 词：胸腺淋巴瘤 正电子发射断层成像/计算机断层成像 代谢参数 纵隔大B细胞淋巴瘤 霍奇金淋巴瘤 

分 类 号：R736.3[医药卫生—肿瘤]