中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2012年
3期
175-179
,共5页
杨文锋%谭国柱%付政%于金明%张永明%孙晓蓉%穆殿斌
楊文鋒%譚國柱%付政%于金明%張永明%孫曉蓉%穆殿斌
양문봉%담국주%부정%우금명%장영명%손효용%목전빈
癌,非小细胞肺%肿瘤分期%体层摄影术,发射型计算机%体层摄影术,X线计算机%脱氧葡萄糖%胸苷
癌,非小細胞肺%腫瘤分期%體層攝影術,髮射型計算機%體層攝影術,X線計算機%脫氧葡萄糖%胸苷
암,비소세포폐%종류분기%체층섭영술,발사형계산궤%체층섭영술,X선계산궤%탈양포도당%흉감
Carcinoma,non-small cell lung%Neoplasm staging%Tomography,emission-computed%Tomography,X-ray computed%Deoxyglucose%Thymidine
目的 比较3′-脱氧-3′-18F-FLT与18F-FDG PET/CT对NSCLC淋巴结分期的诊断价值,探讨肿瘤FLT和FDG摄取与细胞周期蛋白Cyclin D1表达的相关性.方法 选择手术治疗的NSCLC患者31例,男22例,女9例,年龄38～84岁.术前2周内行18F-FLT和18F-FDG PET/CT检查,术后行病理和转移淋巴结的免疫组织化学Cyclin D1检测.以病理诊断为“金标准”,评价18F-FLT和18F-FDG PET/CT显像对NSCLC的诊断价值.应用SPSS 12.0软件,计数资料行,检验,组间SUV.差异行方差分析,SUV.与Cyclin D1的表达行直线相关分析.结果 FLT和FDG PET/CT对NSCLC原发灶诊断的灵敏度分别为74.2％(23/31)和93.5％ (29/31),二者差异有统计学意义(x2=4.29,P =0.038).FLT PET/CT对NSCLC区域淋巴结诊断的灵敏度、特异性、准确性和阳性预测值分别为65％(39/60)、98％ (291/296)、93％(330/356)和85％(39/46),FDG PET/CT则分别为85％(51/60)、84％(249/296)、84％(300/356)和52％(51/98),二者差异有统计学意义(x2值分别为6.40、32.89、12.40、14.32和2.98,P均＜0.05).对于N分期,FLT PET/CT能使77.4％(24/31)的NSCLC患者分期正确,6.5％(2/31)的患者分期过高(假阳性),16.1％(5/31)的患者分期过低(假阴性);而FDG PET/CT相应数据则分别为77.4％(24/31)、16.1％(5/31)和6.5％(2/31).原发灶18F-FLT SUVmax与肿瘤组织Cyclin D1表达呈正相关(r=0.644,P＜0.01),FDG SUVmax则无相关性(r=0.293,P＞0.05).临床分期越晚,FLT SUVmax越高(F=12.2,P＜0.05),但FDG SUVmax则无此趋势(F=3.1,P＞0.05)；二者在不同病理类型、分化程度之间差异无统计学意义(F=1.1、0.6、0.8和1.1,P均＞0.05).结论 与FDG PET/CT相比,FLT PET/CT对NSCLC淋巴结分期过低的患者多,而分期过高的患者少；对区域淋巴结诊断灵敏度降低,但有更高的特异性、准确性和阳性预测值.肿瘤FLT摄取与细胞周期蛋白Cyclin D1的表达有相关性.
目的 比較3′-脫氧-3′-18F-FLT與18F-FDG PET/CT對NSCLC淋巴結分期的診斷價值,探討腫瘤FLT和FDG攝取與細胞週期蛋白Cyclin D1錶達的相關性.方法 選擇手術治療的NSCLC患者31例,男22例,女9例,年齡38～84歲.術前2週內行18F-FLT和18F-FDG PET/CT檢查,術後行病理和轉移淋巴結的免疫組織化學Cyclin D1檢測.以病理診斷為“金標準”,評價18F-FLT和18F-FDG PET/CT顯像對NSCLC的診斷價值.應用SPSS 12.0軟件,計數資料行,檢驗,組間SUV.差異行方差分析,SUV.與Cyclin D1的錶達行直線相關分析.結果 FLT和FDG PET/CT對NSCLC原髮竈診斷的靈敏度分彆為74.2％(23/31)和93.5％ (29/31),二者差異有統計學意義(x2=4.29,P =0.038).FLT PET/CT對NSCLC區域淋巴結診斷的靈敏度、特異性、準確性和暘性預測值分彆為65％(39/60)、98％ (291/296)、93％(330/356)和85％(39/46),FDG PET/CT則分彆為85％(51/60)、84％(249/296)、84％(300/356)和52％(51/98),二者差異有統計學意義(x2值分彆為6.40、32.89、12.40、14.32和2.98,P均＜0.05).對于N分期,FLT PET/CT能使77.4％(24/31)的NSCLC患者分期正確,6.5％(2/31)的患者分期過高(假暘性),16.1％(5/31)的患者分期過低(假陰性);而FDG PET/CT相應數據則分彆為77.4％(24/31)、16.1％(5/31)和6.5％(2/31).原髮竈18F-FLT SUVmax與腫瘤組織Cyclin D1錶達呈正相關(r=0.644,P＜0.01),FDG SUVmax則無相關性(r=0.293,P＞0.05).臨床分期越晚,FLT SUVmax越高(F=12.2,P＜0.05),但FDG SUVmax則無此趨勢(F=3.1,P＞0.05)；二者在不同病理類型、分化程度之間差異無統計學意義(F=1.1、0.6、0.8和1.1,P均＞0.05).結論 與FDG PET/CT相比,FLT PET/CT對NSCLC淋巴結分期過低的患者多,而分期過高的患者少；對區域淋巴結診斷靈敏度降低,但有更高的特異性、準確性和暘性預測值.腫瘤FLT攝取與細胞週期蛋白Cyclin D1的錶達有相關性.
목적 비교3′-탈양-3′-18F-FLT여18F-FDG PET/CT대NSCLC림파결분기적진단개치,탐토종류FLT화FDG섭취여세포주기단백Cyclin D1표체적상관성.방법 선택수술치료적NSCLC환자31례,남22례,녀9례,년령38～84세.술전2주내행18F-FLT화18F-FDG PET/CT검사,술후행병리화전이림파결적면역조직화학Cyclin D1검측.이병리진단위“금표준”,평개18F-FLT화18F-FDG PET/CT현상대NSCLC적진단개치.응용SPSS 12.0연건,계수자료행,검험,조간SUV.차이행방차분석,SUV.여Cyclin D1적표체행직선상관분석.결과 FLT화FDG PET/CT대NSCLC원발조진단적령민도분별위74.2％(23/31)화93.5％ (29/31),이자차이유통계학의의(x2=4.29,P =0.038).FLT PET/CT대NSCLC구역림파결진단적령민도、특이성、준학성화양성예측치분별위65％(39/60)、98％ (291/296)、93％(330/356)화85％(39/46),FDG PET/CT칙분별위85％(51/60)、84％(249/296)、84％(300/356)화52％(51/98),이자차이유통계학의의(x2치분별위6.40、32.89、12.40、14.32화2.98,P균＜0.05).대우N분기,FLT PET/CT능사77.4％(24/31)적NSCLC환자분기정학,6.5％(2/31)적환자분기과고(가양성),16.1％(5/31)적환자분기과저(가음성);이FDG PET/CT상응수거칙분별위77.4％(24/31)、16.1％(5/31)화6.5％(2/31).원발조18F-FLT SUVmax여종류조직Cyclin D1표체정정상관(r=0.644,P＜0.01),FDG SUVmax칙무상관성(r=0.293,P＞0.05).림상분기월만,FLT SUVmax월고(F=12.2,P＜0.05),단FDG SUVmax칙무차추세(F=3.1,P＞0.05)；이자재불동병리류형、분화정도지간차이무통계학의의(F=1.1、0.6、0.8화1.1,P균＞0.05).결론 여FDG PET/CT상비,FLT PET/CT대NSCLC림파결분기과저적환자다,이분기과고적환자소；대구역림파결진단령민도강저,단유경고적특이성、준학성화양성예측치.종류FLT섭취여세포주기단백Cyclin D1적표체유상관성.
Objective To compare the efficiency of 18F-FLT and 18F-FDG PET/CT in lymph node staging for patients with NSCLC,and to explore the correlation between FLT/FDG uptake and Cyclin D1 expression.Methods Thirty-one patients (22 men and 9 women ; ranging from 38 to 84 y) with NSCLC underwent both 18 F-FLT and 18 F-FDG PET/CT scans before surgical resection (tumor resection and lymphnode dissection).Histopathologic results were considered the gold standard.Cyclin D1 immunohistochemistry was regarded as the tumor cell proliferation index.Analysis of variance,x2 test and linear correlation were performed using SPSS 12.0.Results The sensitivity,specificity,accuracy and positive predictive value of 18 F-FLT PET/CT for lymph node staging were 65％(39/60),98％(291/296),93％(330/356)and 85％(39/46),and for 1sF-FDG PET/CT,were 85％(51/60),84％ (249/296),84％(300/356)and 52％(51/98),respectively (x2=6.40,32.89,12.40,14.32,2.98,all P＜0.05).For N staging,77.4％(24/31) patients were correctly staged,6.5％ (2/31) were overstaged,and 16.1％(5/31) were understaged by 18 F-FLT PET/CT; while those results for 18 F-FDG PET/CT were 77.4％ (24/31),16.1％(5/31) and 6.5％(2/31),respectively.Tumor FLT SUVmax was correlated significantly with Cyclin D1 expression (r=0.644,P＜0.01),but FDG SUV,max was not (r=0.293,P＞0.05).FLT SUVmax in late stages was higher than that in early stages (F=12.2,P＜0.05).However,there was no significant difference between FDG SUVmax of different stages (F=3.1,P＞0.05).There was no significant difference between SUVmax of FLT and FDG among different pathological types (F=1.1,0.6,both P＞0.05) and differentiation(F=0.8,1.1,both P＞0.05).Conclusions NSCLC patients are more frequently understaged but less frequently overstaged during N staging by 18F-FLT PET/CT compared with 18F-FDG PET/CT.18F-FLT PET/CT has lower sensitivity,but higher specificity,accuracy and positive predictive value for N staging of NSCLC.FLT uptake and Cyclin D1 expression is correlated in NSCLC.
