王珍珍,李啸天,牟兴宇,曾钰龍,崇维霞,秦杰,黎祖国,赵雪芹,伍杨,徐翠萍,付巍.18F-FDG PET/CT半定量参数预测临床Ⅰa~Ⅲa期肺腺癌经气腔播散[J].中国医学影像技术,2024,40(5):735~739
18F-FDG PET/CT半定量参数预测临床Ⅰa~Ⅲa期肺腺癌经气腔播散
18F-FDG PET/CT semi-quantitative parameters for predicting clinical stage Ⅰa—Ⅲa lung adenocarcinoma spreading through air spaces
投稿时间:2023-12-14  修订日期:2024-01-29
DOI:10.13929/j.issn.1003-3289.2024.05.022
中文关键词:  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
英文关键词:lung neoplasms  adenocarcinoma  neoplasm metastasis  positron-emission tomography  tomography, X-ray computed  fluorodeoxyglucose F18
基金项目:广西壮族自治区卫生健康委自筹经费科研课题(Z-C20230836)。
作者单位E-mail
王珍珍 桂林医学院附属医院核医学科, 广西 桂林 541000  
李啸天 桂林医学院附属医院放射科, 广西 桂林 541000  
牟兴宇 桂林医学院附属医院核医学科, 广西 桂林 541000  
曾钰龍 桂林医学院附属医院核医学科, 广西 桂林 541000  
崇维霞 桂林医学院附属医院核医学科, 广西 桂林 541000  
秦杰 桂林医学院附属医院核医学科, 广西 桂林 541000  
黎祖国 桂林医学院附属医院核医学科, 广西 桂林 541000  
赵雪芹 桂林医学院附属医院核医学科, 广西 桂林 541000  
伍杨 桂林医学院附属医院核医学科, 广西 桂林 541000  
徐翠萍 桂林医学院附属医院核医学科, 广西 桂林 541000  
付巍 桂林医学院附属医院核医学科, 广西 桂林 541000 13977385850@126.com 
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中文摘要:
      目的 观察18F-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18F-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(SUVmax、SUVmean、SUVpeak),最大、平均及峰值瘦体标准摄取值(SULmax、SULmean、SULpeak)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、SUVmax及SULmax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 18F-FDG PET/CT参数SUVmax及SULmax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。
英文摘要:
      Objective To observe the value of 18F-FDG PET/CT semi-quantitative parameters for predicting spread through air spaces (STAS) of clinical stage Ⅰa—Ⅲa lung adenocarcinoma. Methods Data of 85 patients with clinical stage Ⅰa—Ⅲa lung adenocarcinoma who underwent preoperative 18F-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 (SUVmax, SUVmean, SUVpeak), as well as the maximum, the mean and the peak standard uptake value normalized by lean body mass (SULmax, SULmean, SULpeak), 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, SUVmax and SULmax were all independent risk factors of STAS of clinical stage Ⅰa—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 18F-FDG PET/CT semi-quantitative parameters SUVmax and SULmax were helpful for predicting STAS of clinical stage Ⅰa—Ⅲa lung adenocarcinoma, and further combination of gender and proportion of micropapillary growth could improve diagnostic efficacy.
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