CAJ | 학술논문

目的：了解18F-FDG PET-CT检查对气管粘膜受累的结节病活动性的评价作用。方法回顾分析结节病气管粘膜受累的患者6例和粘膜未受累的患者14例的临床资料，对18F-FDG PET-CT检查肺部病灶、肺门、纵隔淋巴结的标准摄取率（SUV）最大值、平均值和血清血管紧张素转换酶、肺泡灌洗液（BALF）中CD4+与CD8+比值、淋巴细胞比例进行对比分析。结果气管腔内有粘膜改变组肺部病灶的SUV最大值/SUV平均值均高于粘膜无改变组（7.04±5.83/5.00±4.69 vs 5.68±3.66/3.82±2.39），但无统计学差异（P=0.565/0.495）；气管腔内有粘膜改变组肺门、纵隔淋巴结的SUV最大值/SUV平均值均明显高于粘膜无改变组（13.28±5.57/10.48±4.43 vs 6.20±1.77/4.52±1.43；13.84±4.35/9.69±2.74 vs 7.16±2.52/5.28±1.77），有统计学差异（P=0.0003/0.0002；P=0.0004/0.0004）。气管腔内有粘膜改变组血清血管紧张素转换酶水平和BALF中CD4+/CD8+比例分别高于粘膜无改变组（60.58±16.3 IU/L vs 49.16±13.3 IU/L；7.30±5.0 vs 2.90±3.1），两者比较均有统计学意义（P=0.045；0.026）。BALF中检测淋巴细胞比例，粘膜改变组虽高于粘膜无改变组[（44.10±10.3）%vs（35.30±12.5%）]，但无统计学意义（P=0.148）。结论气管粘膜受累是活动性结节病的表现之一，18F-FDG PET-CT检查为评价支气管粘膜受累结节病的活动性提供了一定的帮助。
목적：료해18F-FDG PET-CT검사대기관점막수루적결절병활동성적평개작용。방법회고분석결절병기관점막수루적환자6례화점막미수루적환자14례적림상자료，대18F-FDG PET-CT검사폐부병조、폐문、종격림파결적표준섭취솔（SUV）최대치、평균치화혈청혈관긴장소전환매、폐포관세액（BALF）중CD4+여CD8+비치、림파세포비례진행대비분석。결과기관강내유점막개변조폐부병조적SUV최대치/SUV평균치균고우점막무개변조（7.04±5.83/5.00±4.69 vs 5.68±3.66/3.82±2.39），단무통계학차이（P=0.565/0.495）；기관강내유점막개변조폐문、종격림파결적SUV최대치/SUV평균치균명현고우점막무개변조（13.28±5.57/10.48±4.43 vs 6.20±1.77/4.52±1.43；13.84±4.35/9.69±2.74 vs 7.16±2.52/5.28±1.77），유통계학차이（P=0.0003/0.0002；P=0.0004/0.0004）。기관강내유점막개변조혈청혈관긴장소전환매수평화BALF중CD4+/CD8+비례분별고우점막무개변조（60.58±16.3 IU/L vs 49.16±13.3 IU/L；7.30±5.0 vs 2.90±3.1），량자비교균유통계학의의（P=0.045；0.026）。BALF중검측림파세포비례，점막개변조수고우점막무개변조[（44.10±10.3）%vs（35.30±12.5%）]，단무통계학의의（P=0.148）。결론기관점막수루시활동성결절병적표현지일，18F-FDG PET-CT검사위평개지기관점막수루결절병적활동성제공료일정적방조。
Objective To explore the value of 18F-FDG PET-CT in evaluating bronchial mucosa involvement in patients with saroidosis. Methods A retrospective analysis was conducted among 6 sarcoidosis patients with and 14 patients without bronchial mucosa involvement to collect the data including the standard uptake value (SUVMax/Mean) of 18F-FDG, serum angiotensin converting enzyme (sACE), and proportion of lymphocytes and CD4+/CD8 +T lymphocyte ratio in bronchoalveolar lavage fluid (BALF). Results The lung focal SUV (Max/Mean) was higher in patients with bronchial mucosa involvement than those without (7.04 ± 5.83/5.00 ± 4.69 vs 5.68 ± 3.66/3.82 ± 2.39), but such differences were not statistically significant (P=0.565/0.495). The SUV(Max/Mean) of the hilum of the lung and the mediastina lymph nodes were significantly higher in patients with bronchial mucosa involvement (13.28±5.57/10.48±4.43 vs 6.20±1.77/4.52±1.43, P=0.0003/0.0002;13.84±4.35/9.69±2.74 vs 7.16±2.52/5.28±1.77, P=0.0004/0.0004). The level of sACE and CD4+/CD8 + T lymphocyte ratio in BALF were also significantly higher in patients with bronchial mucosa involvement (60.58 ± 16.3 vs 49.16 ± 13.3 IU/L, P=0.045;7.30 ± 5.0 vs 2.90 ± 3.1, P=0.026). The proportion of lymphocytes in BALF was comparable between the patients with and without bronchial mucosa involvement (44.10±10.3%vs 35.30 ± 12.5%, P=0.148). Conclusions For patients with saroidosis, 18F-FDG PET-CT is useful in evaluating bronchial mucosa involvement, which is one of the key features of active sarcoidosis.