肺癌18F-FDG-PETCT的SUVmax与淋巴结转移及肺癌肿瘤标志物之间的关系研究

目的:研究肺癌18F-FDG-PETCT的SUVmax(最大标准摄取值)与肺癌淋巴结转移、肺癌肿瘤标志物、肿瘤大小及临床病理类型之间的关系。方法:经病理确认的98例肺癌住院患者,术前一周内均行18F-FDG PET-CT检查肿块大小、SUVmax及肺门或纵隔淋巴结转移情况;并进行肿瘤标志物神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)和细胞角蛋白片(CYFRA21-1)检查,统计学分析检测结果。结果:原发灶SU-Vmax与原发灶大小之间存在相关性(r=0.497,P<0.05),与单个肿瘤标志物的值之间无明显相关性。整体分析时肺门或纵隔淋巴结转移组与无转移组的原发灶SUVmax均值之间差异无统计学意义,腺癌肺门或纵隔淋巴结转移组及无转移组的SUVmax均数之间差异有统计学意义(P<0.05)。鳞癌肺门或纵隔淋巴结转移组及无转移组的SUVmax均数之间差别无统学意义(P=0.721)。肺鳞癌与腺癌SUVmax均值之间比较差异有统计学意义(P=0.001);细支气肺泡癌与其它腺癌SUVmax均值之间差异有统计学意义(P<0.05)。结论:在病理类型不明确的情况下原发灶SUVmax的高低并不能预测淋巴结转移的有无,肺腺癌原发灶FDG代谢活性与肺门和(或)纵隔淋巴结转移有关,淋巴结转移率随着肿块SUVmax的增加而增加;肺鳞癌FDG代谢活性与肺门和(或)纵隔淋巴结转移无关。SUVmax与病理类型有关,鳞癌SUVmax较高,腺癌较低,细支气管肺泡癌则更低。

Relationship among SUVmax of primary lung cancer ,lymph node metastasis,tumor markers by using 18F-FDG-PETCT

Objective: To research the relationships among the maximal standard uptake value(SUV max) of primary lung cancer,lymph node metastasis,tumor markers,tumor size and pathological type by using 18F-FDG-PETCT.Methods:Total of 98 patients with lung cancer diagnosed by pathological examination were performed PETCT a week before surgery,we measured the size of tumor,SUVmax of primary lung cancer and the cases of hilar or mediastinal lymph node metastasis,tumor marker examination including NSE,CEA,CYFRA21-1.Results: SUVmax was correlated with primary tumor size(r=0.497,P<0.05),had no significant correlation with single tumor marker.Further analysis of lung adenocarcinoma,the difference of mean SUVmax between with and without lymph node metastasis was significant(P<0.05);there was no significant difference among the squamous cell carcinomas(P=0.721).The difference of the mean SUVmax between adenocarcinoma and squamous cell carcinomas was significant(P=0.001);the difference of mean SUVmax between bronchioloalveolar carcinoma and the other adenocarcinomas were statistically significant(P<0.05).Conclusion:The level of primary tumor SUVmax could not predict lymph node metastasis if we could not ascertain the pathology type of lung mass.The frequency of lymph node metastasis increased with the increase of SUVmax in lung adenocarcinoma,there was no correlation between FDG metabolic activity and hilar and(or) mediastinal lymph node metastasis in squamous cell carcinomas.SUVmax matters with pathology type of lung cancer,squamous cell carcinomas was higher than lung adenocarcinoma,bronchioloalveolar carcinoma was much lower.