CAJ | 학술논문

目的评价18F-FDG PET/CT在Castleman病(CD)的临床分型、疗效评价及转化监测中的应用价值.方法回顾性分析14例CD患者[年龄(45.64±14.30)岁,男、女各7例]的18F-FDGPET/CT影像表现(病灶数量、分布、SUVmax),比较不同临床分型、病理类型、病理转化患者的影像表现,并对4例化疗后复查18 F-FDG PET/CT患者的病灶影像学变化进行记录.数据比较采用Mann-Whitney及Kruskal-Wallis秩和检验.结果 12例病理未发生转化的CD患者,化疗前18 F-FDG PET/CT检查均有1个或多个淋巴结肿大且伴有葡萄糖代谢增高,SUVmax3.94± 1.44(1.9 ～ 6.8)；临床类型为单中心(2/12)与多中心(10/12) CD的SUV max分别为4.55±3.18和3.82±1.14,差异无统计学意义(Z=0.22,P＞0.05)；病理类型分别为透明血管型(4/12)、浆细胞型(6/12)、混合型(2/12) CD的SUVmax分别为3.56±0.96、4.73± 1.41和2.30±0.57,差异无统计学意义(x2=4.74,P＞0.05).4例(4/12)化疗后复查PET/CT的患者中,3例病灶完全消失,1例病灶缩小、代谢减低.2例(2/14)发生病理转化的患者,SUVmax10.85±2.05,高于未转化者(3.94±1.44；Z=-2.19,P＜0.05).结论 18F-FDGPET/CT对于指导CD的临床分型、评价化疗疗效和监测病理转化均有一定的应用价值.
목적 평개18F-FDG PET/CT재Castleman병(CD)적림상분형、료효평개급전화감측중적응용개치.방법 회고성분석14례CD환자[년령(45.64±14.30)세,남、녀각7례]적18F-FDGPET/CT영상표현(병조수량、분포、SUVmax),비교불동림상분형、병리류형、병리전화환자적영상표현,병대4례화료후복사18 F-FDG PET/CT환자적병조영상학변화진행기록.수거비교채용Mann-Whitney급Kruskal-Wallis질화검험.결과 12례병리미발생전화적CD환자,화료전18 F-FDG PET/CT검사균유1개혹다개림파결종대차반유포도당대사증고,SUVmax3.94± 1.44(1.9 ～ 6.8)；림상류형위단중심(2/12)여다중심(10/12) CD적SUV max분별위4.55±3.18화3.82±1.14,차이무통계학의의(Z=0.22,P＞0.05)；병리류형분별위투명혈관형(4/12)、장세포형(6/12)、혼합형(2/12) CD적SUVmax분별위3.56±0.96、4.73± 1.41화2.30±0.57,차이무통계학의의(x2=4.74,P＞0.05).4례(4/12)화료후복사PET/CT적환자중,3례병조완전소실,1례병조축소、대사감저.2례(2/14)발생병리전화적환자,SUVmax10.85±2.05,고우미전화자(3.94±1.44；Z=-2.19,P＜0.05).결론 18F-FDGPET/CT대우지도CD적림상분형、평개화료료효화감측병리전화균유일정적응용개치.
Objective To assess the value of 18F-FDG PET/CT in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of Castleman's disease (CD).Methods Fourteen pathologically diagnosed CD patients (7 males,7 females; mean age:(45.64±14.30) years) were retrospectively reviewed.18F-FDG PET/CT was performed before chemotherapy in all patients and 4 of 14 patients were reexamined after the treatment.The study parameters included histopathological results,sites,number and highest SUVmax of the lesions.Mann-Whitney and Kruskal-Wallis tests were used for data analysis.Results Of all the 12 patients without histopathological transformation,one or more enlarged and metabolically active lymph nodes were found in each patient (SUVmax =3.94± 1.44,range:1.9-6.8),including 2 unicentric CD (UCD) and 10 multicentric CD (MCD).There was no statistically significant difference of SUVmam between UCD and MCD (4.55±3.18 vs 3.82±1.14; Z=0.22,P＞0.05).There was also no significant difference of SUVmax among different pathological types (hyaline-vascular CD (4/12):3.56±0.96,plasma cell CD (6/12):4.73±1.41,mixed CD (2/12):2.30±0.57; x2 =4.74,P＞0.05).For the 4 patients with follow-up PET/CT after chemotherapy,the lesion activity was normalized in 3 patients and clearly reduced in 1 patient.The SUVmax of 2 patients with histopathological transformation (10.85±2.05) was significantly higher than that without transformation (3.94± 1.44; Z=-2.19,P＜0.05).Conclusion 18F-FDG PET/CT may play an important role in clinical classification,monitoring of chemotherapeutic response and surveillance of histopathological transformation of CD.