摘要
目的分析无功能胰腺神经内分泌肿瘤(NF-pNENs)^(18)F-FDG PET/CT影像特点,并分析其与病理和患者预后的关系。方法回顾性纳入北京协和医院2011年1月至2017年7月间35例经病理证实的NF-pNENs患者[男17例,女18例,年龄(51±12)岁],均行^(18)F-FDG PET/CT显像。收集患者临床资料并随访,统计病灶数量,测量病灶最大径、SUV_(max)和肿瘤/肝SUV_(max)比值(T/L)等PET/CT图像参数。采用Mann-Whitney U检验或Kruskal-Wallis秩和检验和Spearman秩相关分析数据。结果35例患者(G1级6例,G2级21例,G3级8例)胰腺肿瘤最大径为3.0(2.1,6.1)cm,SUV_(max)为5.5(4.0,8.9),PET/CT显像阳性32例。囊性1例,伴钙化2例,胰胆管扩张3例。10例出现转移,其中8例为肝转移。G1~G3级肿瘤T/L差异有统计学意义[1.23(0.60,2.00)、3.05(1.80,4.00)和3.90(1.90,7.60);H=8.29,P=0.016];而对应的SUV_(max)与肿瘤最大径差异均无统计学意义(H值:4.34和3.37,P值:0.114和0.186)。胰腺病灶T/L[2.78(1.48,3.94)]与细胞增殖核抗原Ki-67指数[8.0(3.0,20.0)]呈正相关(rs=0.631,P<0.001)。有随访结果的27例中,20例完全缓解或病情稳定者胰腺原发病灶T/L明显低于7例进展或死亡患者[2.1(1.2,3.2)与7.5(3.4,13.4);z=-3.37,P=0.001]。结论^(18)F-FDG PET/CT显像可较好地显示NF-pNENs原发灶及转移灶;原发灶T/L较SUV_(max)能更好地反映肿瘤增殖活性(基于Ki-67指数),对预后判断有所帮助。
Objective To analyze ^(18)F-FDG PET/CT imaging features of non-functional pancreatic neuroendocrine neoplasms(NF-pNENs)and investigate its correlation with pathology and prognosis.Methods A total of 35 cases(17 males,18 females;age(51±12)years)of pathologically confirmed NF-pNENs who underwent pretherapeutic ^(18)F-FDG PET/CT from January 2011 to July 2017 in Peking Union Medical College Hospital were retrospectively enrolled.Clinical data were collected and patients were followed up.PET/CT parameters including number and _(max)imum diameter of lesions,SUV_(max) and pancreatic tumor-to-liver ratio(T/L)were measured.Mann-Whitney U test and Kruskal-Wallis rank sum test,Spearman correlation analysis were used to analyze the data.Results Among the included 35 NF-pNENs patients(G1,n=6;G2,n=21;G3,n=8)with _(max)imum diameter of 3.0(2.1,6.1)cm and SUV_(max) of 5.5(4.0,8.9),32 were positive in PET/CT.There were 1 patient with cystic,2 with calcification and 3 with dilatation of pancreaticobiliary duct.Among 10 patients with metastases,8 revealed multiple liver metastases.There was statistical difference of T/L among G1-G3 tumor(1.23(0.60,2.00),3.05(1.80,4.00),3.90(1.90,7.60);H=8.29,P=0.016),but there were no statistical differences of SUV_(max) or _(max)imum diameter among G1-G3 tumor(H values:4.34,3.37,P values:0.114,0.186).There was a significant correlation between T/L(2.78(1.48,3.94))and Ki-67 index(8.0(3.0,20.0);rs=0.631,P<0.001).Among 27 patients with available follow-up results,T/L in patients with complete remission or stable disease(n=20)was statistically lower than that in patients with progressive disease or death(n=7)(2.1(1.2,3.2)vs 7.5(3.4,13.4);z=-3.37,P=0.001).Conclusions ^(18)F-FDG PET/CT can detect primary and metastatic lesions of NF-pNENs.T/L can better reflect the proliferative activity based on Ki-67 index than SUV_(max) and it may be favorable on prognostic value.
作者
王佩佩
霍力
刘宇
崔瑞雪
景红丽
李方
Wang Peipei;Huo Li;Liu Yu;Cui Ruixue;Jing Hongli;Li Fang(Department of Nuclear Medicine,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine,Beijing 100730,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第3期139-143,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
