原发胃癌~(18)F-FDG PET/CT代谢参数与临床病理特征的相关性
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摘要
目的探讨原发胃癌18F-FDG PET/CT代谢参数与临床病理特征的相关性。方法回顾性分析我院经手术病理证实的44例胃癌患者的18F-FDG PET/CT显像特征和临床资料,记录胃癌原发灶的最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))及代谢体积(MTV),并计算病灶糖酵解总量(TLG)。分别比较不同肿瘤T分期、N分期、病理分期及细胞组织分化程度组间上述代谢参数的差异,并分析上述代谢参数与临床病理特征的相关性。结果 44例原发胃癌的SUV_(max)、SUV_(mean)、MTV及TLG分别为5.81(3.45,7.77)、3.42(1.87,4.37)、14.80(9.02,25.19)cm~3及42.03(18.89,107.87)g。不同T分期胃癌原发灶的SUV_(max)、SUV_(mean)、MTV、TLG差异均无统计学意义(P均>0.05);不同N分期及病理分期胃癌原发灶的MTV、TLG差异均有统计学意义(P均<0.05),而SUV_(max)、SUV_(mean)差异均无统计学意义(P均>0.05);不同细胞组织分化程度胃癌原发灶SUV_(max)、SUV_(mean)差异有统计学意义(P均<0.05),而MTV、TLG差异无统计学意义(P均>0.05)。SUV_(max)、SUV_(mean)与肿瘤T分期及细胞组织分化程度呈中度正相关(P均<0.05),与肿瘤N分期及病理分期均无显著相关性(P均>0.05);MTV及TLG与肿瘤T分期、N分期及病理分期均呈中度正相关(P均<0.05);MTV及TLG与肿瘤细胞组织分化程度均无显著相关(P均>0.05)。结论胃癌原发灶的~(18)F-FDG PET/CT代谢参数可反映肿瘤的部分临床病理特征,有助于临床制定个体化治疗方案。
Objective To investigate the correlation of metabolic parameters of 18 F-FDG PET/CT and clinicopathological factors of gastric cancer.Methods 18 F-FDG PET/CT characteristics and clinical data of histopathologically proved gastric cancer in 44 patients were reviewed retrospectively.The maximum standardized uptake value(SUV_(max)),mean standardized uptake value(SUV_(mean))and metabolic tumor volume(MTV)of primary lesions were measured,and total lesion glycolysis(TLG)was calculated.The differences of the above metabolic parameters among different T-stage,N-stage,pathological stage and cell differentiated degree of tumors were compared,and the correlation of metabolic parameters and clinicopathological factors was analyzed.Results SUV_(max),SUV_(mean),MTV and TLG of 44 primary lesions was 5.81(3.45,7.77),3.42(1.87,4.37),14.80(9.02,25.19)cm~3 and 42.03(18.89,107.87)g,respectively.There was no statistical difference of SUV_(max),SUV_(mean),MTV nor TLG between different T-stage of primary lesions(all P>0.05).There were statistical differences of MTV and TLG of different N-stage and pathological stage groups(all P<0.05).There was no statistical difference of SUV_(max)and SUV_(mean)of different N-stage and pathological stage groups(all P>0.05).There were statistical differences of SUV_(max)and SUV_(mean)among different cell differentiated degrees(both P<0.05).There was no statistical difference of MTV and TLG among different cell differentiated degrees(both P>0.05).SUV_(max)and SUV_(mean) were positively correlated with T-stage and cell differentiated degree of tumors(all P<0.05),respectively.There was no significant correlation of SUV_(max),SUV_(mean)with N-stage nor pathological stage of tumors(all P>0.05).MTV and TLG were positively correlated with T-stage,N-stage with pathological stage of tumors(all P<0.05),respectively.There was no significant correlation of MTV,TLG with pathological stage of tumors(all P>0.05).Conclusion ~(18)F-FDG PET/CT metabolic parameters of primary gastric cancer could reflect partial clinicopathological characteristics,therefore being helpful to individual treatment planning.
Objective To investigate the correlation of metabolic parameters of 18 F-FDG PET/CT and clinicopathological factors of gastric cancer.Methods 18 F-FDG PET/CT characteristics and clinical data of histopathologically proved gastric cancer in 44 patients were reviewed retrospectively.The maximum standardized uptake value(SUV_(max)),mean standardized uptake value(SUV_(mean))and metabolic tumor volume(MTV)of primary lesions were measured,and total lesion glycolysis(TLG)was calculated.The differences of the above metabolic parameters among different T-stage,N-stage,pathological stage and cell differentiated degree of tumors were compared,and the correlation of metabolic parameters and clinicopathological factors was analyzed.Results SUV_(max),SUV_(mean),MTV and TLG of 44 primary lesions was 5.81(3.45,7.77),3.42(1.87,4.37),14.80(9.02,25.19)cm~3 and 42.03(18.89,107.87)g,respectively.There was no statistical difference of SUV_(max),SUV_(mean),MTV nor TLG between different T-stage of primary lesions(all P>0.05).There were statistical differences of MTV and TLG of different N-stage and pathological stage groups(all P<0.05).There was no statistical difference of SUV_(max)and SUV_(mean)of different N-stage and pathological stage groups(all P>0.05).There were statistical differences of SUV_(max)and SUV_(mean)among different cell differentiated degrees(both P<0.05).There was no statistical difference of MTV and TLG among different cell differentiated degrees(both P>0.05).SUV_(max)and SUV_(mean) were positively correlated with T-stage and cell differentiated degree of tumors(all P<0.05),respectively.There was no significant correlation of SUV_(max),SUV_(mean)with N-stage nor pathological stage of tumors(all P>0.05).MTV and TLG were positively correlated with T-stage,N-stage with pathological stage of tumors(all P<0.05),respectively.There was no significant correlation of MTV,TLG with pathological stage of tumors(all P>0.05).Conclusion ~(18)F-FDG PET/CT metabolic parameters of primary gastric cancer could reflect partial clinicopathological characteristics,therefore being helpful to individual treatment planning.
引文
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[8]Na SJ,o JH,Park JM.et al.Prognostic value of metabolic parameters on preoperative 18F-Fluorodeoxyglucose positron emission tomography/computed tomography in patients with stageⅢgastric cancer.Oncotarget,2016,7(39):63968-63980.
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[11]卫勃,陈凛,李杰.葡萄糖转运蛋白1在胃癌组织及转移淋巴结中的表达及其与预后的关系.中华胃肠外科杂志,2009,12(3):277-280.
[12]朱娅华,邓玮玮,范敏,等.18F-FDG PET/CT显像在胃癌分期及治疗方案制定中的应用价值.国际放射医学核医学杂志,2018,42(1):15-20.
[13]Charalampakis N,Xiao L,Elimova E,et al.Initial standardized uptake value of positron emission tomography influences the prognosis of patients with localized gastric adenocarcinoma treated preoperatively.Oncology,2015,89(6):305-310.
[14]Perlaza P,Ortín J,Pagès M,et al.Should 18F-FDG PET/CTbe routinely performed in the clinical staging of locally advanced gastric adenocarcinoma?Clin Nucl Med,2018,43(6):402-410.
[15]Park JS,Lee N,Beom SH.The prognostic value of volumebased parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status.Gastric Cancer,2017,21(2):213-224.
[16]王瑜,张云,彭程.PET-CT18F-FDG的摄取度定量评价胃癌分化程度的价值.医学影像学杂志,2015,25(12):2157-2160.
[2]王云玲,宋娟,杜江华,等.双源CT能谱成像定性评估胃癌转移淋巴结.中国医学影像技术,2018,34(5):705-708.
[3]Brenkman HJF,Gertsen EC,Vegt E,et al.Evaluation of PETand laparoscopy in STagIng advanced gastric cancer:Amulticenter prospective study(PLASTIC-study).BMC Cancer,2018,8(1):450.
[4]周锦,周东亚,张银,等.18 F-FDG PET/CT代谢参数与食管癌临床病理特征的相关性.中国医学影像技术,2018,34(7):1024-1027.
[5]Kim SG,Seo HS,Lee HH,et al.Comparison of the differences in survival rates between the 7th and 8th editions of the AJCCTNM staging system for gastric adenocarcinoma:A singleinstitution study of 5,507patients in Korea.J Gastric Cancer,2017,17(3):212-219.
[6]Stahl A,Ott K,Weber WA,et al.FDG PET imaging of locally advanced gastric carcinomas:Correlation with endoscopic and histopathological findings.Eur J Nucl Med Mol Imaging,2003,30(2):288-295.
[7]Na SJ,Park HL,O JH,et al.Correlation between infection status of Epstein-Barr virus and 18F-fluorodeoxyglucose uptake in patients with advanced gastric cancer.In Vivo,2017,31(4):749-753.
[8]Na SJ,o JH,Park JM.et al.Prognostic value of metabolic parameters on preoperative 18F-Fluorodeoxyglucose positron emission tomography/computed tomography in patients with stageⅢgastric cancer.Oncotarget,2016,7(39):63968-63980.
[9]Altini C,Niccoli Asabella A,Di Palo A,et al.18F-FDG PET/CTrole in staging of gastric carcinomas:Comparison with conventional contrast enhancement computed tomography.Medicine(Baltimore),2015,94(20):1-8.
[10]Kurahara H,Maemura K,Mataki Y,et al.Significance of glucose transporter type 1(glut-1)expression in the therapeutic strategy for pancreatic ductal adenocarcinoma.Ann Surg Oncol,2018,25(5):1432-1439.
[11]卫勃,陈凛,李杰.葡萄糖转运蛋白1在胃癌组织及转移淋巴结中的表达及其与预后的关系.中华胃肠外科杂志,2009,12(3):277-280.
[12]朱娅华,邓玮玮,范敏,等.18F-FDG PET/CT显像在胃癌分期及治疗方案制定中的应用价值.国际放射医学核医学杂志,2018,42(1):15-20.
[13]Charalampakis N,Xiao L,Elimova E,et al.Initial standardized uptake value of positron emission tomography influences the prognosis of patients with localized gastric adenocarcinoma treated preoperatively.Oncology,2015,89(6):305-310.
[14]Perlaza P,Ortín J,Pagès M,et al.Should 18F-FDG PET/CTbe routinely performed in the clinical staging of locally advanced gastric adenocarcinoma?Clin Nucl Med,2018,43(6):402-410.
[15]Park JS,Lee N,Beom SH.The prognostic value of volumebased parameters using 18F-FDG PET/CT in gastric cancer according to HER2 status.Gastric Cancer,2017,21(2):213-224.
[16]王瑜,张云,彭程.PET-CT18F-FDG的摄取度定量评价胃癌分化程度的价值.医学影像学杂志,2015,25(12):2157-2160.