^(18)F-FDG PET/CT半定量参数预测临床Ⅰa~Ⅲa期肺腺癌经气腔播散  

^(18)F-FDG PET/CT semi-quantitative parameters for predicting clinical stageⅠa-Ⅲa lung adenocarcinoma spreading through air spaces

作　　者：王珍珍 李啸天[2] 牟兴宇 曾钰龍 崇维霞 秦杰 黎祖国 赵雪芹 伍杨 徐翠萍 付巍[1] WANG Zhenzhen;LI Xiaotian;MU Xingyu;ZENG Yulong;CHONG Weixia;QIN Jie;LI Zuguo;ZHAO Xueqin;WU Yang;XU Cuiping;FU Wei(Department of Nuclear Medicine,Affiliated Hospital of Guilin Medical University,Guilin 541000,China;Department of Radiology,Affiliated Hospital of Guilin Medical University,Guilin 541000,China)

机构地区：[1]桂林医学院附属医院核医学科,广西桂林541000 [2]桂林医学院附属医院放射科,广西桂林541000

出　　处：《中国医学影像技术》2024年第5期735-739,共5页Chinese Journal of Medical Imaging Technology

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(Z-C20230836)。

摘　　要：目的观察^(18)F-FDG PET/CT半定量参数预测临床Ⅰa~Ⅲa期肺腺癌经气腔播散(STAS)的价值。方法回顾性收集85例于术前接受^(18)F-FDG PET/CT检查的Ⅰa~Ⅲa期肺腺癌患者,根据病理显示有无STAS分为阳性组(n=23)及阴性组(n=62);比较组间临床及PET/CT所见,并以logistic分析观察其预测STAS的效能。结果组间患者性别、癌胚抗原、临床分期、病理分级、微乳头状生长及其占比差异均有统计学意义(P均<0.05)。阳性组最大、平均及峰值标准摄取值(SUV max、SUV mean、SUV peak),最大、平均及峰值瘦体标准摄取值(SUL_(max)、SUL_(mean)、SUL_(peak))和病灶糖酵解总量(TLG)均显著高于阴性组(P均<0.05)。性别、微乳头状生长方式占比、SUV max及SUL_(max)均为Ⅰa~Ⅲa期肺腺癌STAS的独立危险因素,以之预测STAS的曲线下面积(AUC)分别为0.666、0.912、0.839及0.842;其联合预测的AUC为0.957。结论^(18)F-FDG PET/CT参数SUV max及SUL_(max)有助于预测临床Ⅰa~Ⅲa期肺腺癌STAS;进一步联合性别及微乳头状生长方式占比可提高诊断效能。Objective To observe the value of^(18)F-FDG PET/CT semi-quantitative parameters for predicting spread through air spaces(STAS)of clinical stageⅠa—Ⅲa lung adenocarcinoma.Methods Data of 85 patients with clinical stageⅠa—Ⅲa lung adenocarcinoma who underwent preoperative^(18)F-FDG PET/CT were retrospectively analyzed.The patients were divided into positive group(n=23)or negative group(n=62)according to whether pathology showed STAS or not.Clinical and PET/CT data were compared between groups,and logistic analysis was performed to explore the efficacy of each parameter for predicting STAS.Results Significant differences of gender,carcinoma embryonic antigen,clinical stage,pathological grade,micropapillary growth and proportion were found between groups(all P<0.05).The maximum,the mean,the peak standard uptake value(SUV max,SUV mean,SUV peak),as well as the maximum,the mean and the peak standard uptake value normalized by lean body mass(SUL_(max),SUL_(mean),SUL_(peak)),also the total lesion glycolysis(TLG)in positive group were all significantly higher than those in negative group(all P<0.05).Patients'gender,proportion of micropapillary growth,SUV max and SUL_(max) were all independent risk factors of STAS of clinical stageⅠa—Ⅲa lung adenocarcinoma.The area under the curve(AUC)of the above parameters for predicting STAS was 0.666,0.912,0.839 and 0.842,respectively,and of the combination was 0.957.Conclusion^(18)F-FDG PET/CT semi-quantitative parameters SUV max and SUL_(max) were helpful for predicting STAS of clinical stageⅠa—Ⅲa lung adenocarcinoma,and further combination of gender and proportion of micropapillary growth could improve diagnostic efficacy.

关 键 词：肺肿瘤 腺癌 肿瘤转移 正电子发射断层显像 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R734.2[医药卫生—肿瘤] R817.4[医药卫生—临床医学]