摘要
目的:本研究旨在通过分析探讨肝癌肝移植术前及术后18F-脱氧葡萄糖(FDG)PET/CT代谢负荷参数变化与患者预后的关系。方法:回顾性分析2013年10月至2017年5月期间术前、术后均行PET/CT检查的肝癌肝移植患者92例。依据多维尔标准将病灶分为PET阴性、弱阳性、强阳性。测量或计算肝癌病灶的最大标准化摄取值(SUV max),瘦体标准摄取值(SUL),肿瘤代谢体积(MTV),计算肿瘤-纵隔摄取比(TMR),肿瘤-正常肝摄取比(TLR),糖醇解总量(TLG),摄取总量(UVP)等代谢参数,分析其与复发的相关性,并分析了多维尔评分与代谢参数的关系及术前及术后代谢负荷参数的变化特征。结果:30例未复发组术前PET的多维尔评分分别为3、4、5分的例数分别为16、7、7例。62例复发,术后复发时间(10.90±10.30)个月。代谢体积参数MTV,TLG,UVP-M,UVP-LB在复发转移组明显增高(P<0.05)。肿瘤多维尔评分较低者肝移植术后预后良好,肿瘤Deauville评分4~5分为复发的重要预测因子。5分的高于4分的代谢参数。复发组的代谢负荷参数高于未复发组。复发组术后复发灶MTV、TLG、UVP-M,UVP-LB低于术前水平。而SUV max、TMR、TLR、SUL与术前水平差异无统计学意义。结论:肝移植术前应精准评估PET/CT多维尔评分及代谢负荷参数,对于高代谢负荷参数患者,术后应早期行PET/CT检查以提高复发及转移的检出,及时进行相关治疗。
Objective The aim of this study was to analyze the relationship between the changes of pre-and post-operation PET/CT metabolic parameters and prognosis for liver cancer patients.Methods A retrospective study was carried out among 92 patients with liver cancer who received liver transplantation and PET/CT examination in our hospital from October 2013 to May 2017.According to Deauville criteria,the lesions were classified into PET negative,weak positive,and strong positive.The metabolic parameters including SUVmax,SUL,MTV,TMR,TLR,TLG,UVP of normal liver parenchyma,liver cancer lesions and mediastinum were measured or calculated.The relationship between metabolic parameters and recurrence was analyzed.The relationship of Deauville score and metabolic parameters and the changing characters of metabolic parameters between the PET/CT of pre and post transplantation were analyzed.Results Thirty cases did not relapse after LT,among which 16,7 and 7 cases had Deauville score of 3,4 and 5 respectively in pre-operation PET/CT.The recurrence time of 62 patients in recurrence group was(10.90±10.30)months.MTV,TLG,UVP-M,UVP-LB in recurrence group were significant higher(P<0.05).Patients with low metabolic parameters show better prognosis than patients with high metabolic parameters.Metabolic parameters of 5 score group were higher than that of 4score.The metabolic parameters of recurrence group were higher than those in non-recurrence group.MTV,TLG,UVP-M,UVP-LB in post-operation PET/CT were lower than those in pre-operation PET/CT,however,SUVmax,TMR,TLR,SUL had no significantly difference.Conclusions PET/CT metabolic burden parameters should be evaluated before LT to select patients with better prognosis.For liver transplantation patients with high metabolic parameters,PET/CT examination should be performed early after surgery to improve the detection of recurrence and metastasis,and relevant treatment should be timely conducted.
作者
丁恩慈
陆东燕
魏利娟
赵炎
沈婕
Ding Enci;Lu Dongyan;Wei Lijuan;Zhao Yan;Shen Jie(Department of Nuclear Medicine,Tianjin First Central Hospital,Tianjing 300192,China)
出处
《中华器官移植杂志》
CAS
2021年第5期293-297,共5页
Chinese Journal of Organ Transplantation
基金
天津市科技计划项目(16ZXMJSY00170)。
