摘要
目的探讨18 F-FDG正电子发射计算机体层显像仪(PET/CT)代谢参数评估结直肠癌(CRC)TNM分期的应用价值。方法回顾性分析2018年1月至2020年1月于首都医科大学附属北京友谊医院行术前全身18 F-FDG PET/CT检查并且有完整临床、病理及影像学资料的CRC患者共38例,分别测量肿瘤组织最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、肿瘤代谢体积(MTV)和病灶糖酵解总量(TLG),采用多元逐步回归分析法和Spearman相关系数分析CRC TNM分期、分化程度与SUVmax、SUVmean、TLG、MTV之间的关系,采用受试者操作特征(ROC)曲线的曲线下面积及cutoff值评价18 F-FDG代谢参数在CRC TNM分期中的诊断效能。结果CRC原发灶SUVmax、MTV和TLG值与肿瘤T分期存在相关性,差异有统计学意义(P=0.002、0.001、0.002),CRC原发灶SUVmean值与肿瘤M分期存在相关性,差异有统计学意义(P<0.05)。诊断效能果显示,在鉴别CRC T3和T4分期时,以SUVmax=18.75为阈值,敏感性为100.0%,特异性为70.6%;以MTV=30.5 cm^3为阈值,敏感性为100.0%,特异性为82.4%;以TLG=275.85 g为阈值,敏感性为100.0%,特异性为88.2%;以SUVmean=11.7为阈值,评估CRC M分期的敏感性为66.7%,特异性为87.0%。结论18 F-FDG PET/CT代谢参数与CRC T和M分期具有相关性,18 F-FDG代谢参数可以作为无创评估CRC临床分期有潜力的影像学指标。
Objective To explore the application of 18 F-FDG positron emission tomography and computed tomography(PET/CT)metabolic parameters in evaluating TNM staging of colorectal cancer.Methods A retrospective analysis of 38 patients with colorectal cancer who underwent full-body 18 F-FDG PET/CT examination before surgery in Beijing Friendship Hospital,Capital Medical University from January 2018 to January 2020 and had complete clinical,pathological and imaging data.The metabolic parameters of maximum standardized uptake value(SUVmax),mean standardized uptake value(SUVmean),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)values were measured,respectively.The relationship between T,N,M stages,differentiated degree and 18 F-FDG parameters of colorectal cancer were analyzed by multiple stepwise regression analysis and Spearman correlation analysis.Area under the curve and cutoff value of receiver operating characteristic(ROC)were used to evaluate the diagnostic efficacy of 18 F-FDG metabolic parameters in TNM staging of colorectal cancer.Results The SUVmax,MTV and TLG values of primary colorectal cancer were correlated with tumor T stage,the differences were statistically significant(P=0.002,0.001 and 0.002),and the SUVmean values of primary colorectal cancer were correlated with tumor M stage,the difference was statistically significant(P<0.05).The diagnostic efficacy results showed SUVmax cut-off value of 18.75 showed sensitivity of 100.0%,specificity of 70.6%,TLG cut-off value of 275.85 g showed sensitivity of 100.0%,specificity of 88.2%and MTV cut-off value of 30.5 cm^3 showed sensitivity of 100.0%,specificity of 82.4%in differential CRC T3 from T4 status.A SUVmean cut-off value of 11.7 showed sensitivity of 66.7%,specificity of 87.0%in predicting CRC M status.Conclusion 18 F-FDG PET/CT metabolic parameters of colorectal cancer are correlated with tumor T and M stages.18 F-FDG metabolic parameters can be used as potential imaging indicators for noninvasively evaluate the clinical stages of colorectal cancer.
作者
张茗昱
杨吉刚
王振常
ZHANG Ming-yu;YANG Ji-gang;WANG Zhen-chang(Department of Nuclear Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《临床和实验医学杂志》
2020年第14期1474-1478,共5页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金(编号:81971642)
北京市“使命”人才计划(编号:SML20150101)
北京学者项目:京人社专家发【2015】160号
北京友谊医院“种子计划”人才项目(编号:YYZZ201919)
北京市博士后面上基金(编号:2020-Z2-022)。
