18F-FDG PET／CT显像对胃淋巴瘤与胃癌的鉴别诊断价值

目的:探讨18F-FDG PET/CT显像在胃淋巴瘤与胃癌中的鉴别诊断意义。方法:回顾性分析我院2017年10月至2021年09月经病理证实的48例胃淋巴瘤患者及66例胃癌患者的临床资料。分析两组患者的年龄、性别、胃部病灶的位置、最大标准化摄取值(maximum standardized uptake value,SUVmax)、血癌胚抗原(carcinoembryonic antigen,CEA) 和血糖类抗原199(glucose antigen 199,CA199)的结果以及胃外组织侵犯的情况。统计学分析使用两独立样本t检验及χ2检验。结果:胃淋巴瘤组与胃癌组患者性别分布无明显差异(P＞0.05)，胃淋巴瘤组患者平均年龄较胃癌组小，差异有统计学意义（P＜0.05）。胃淋巴瘤组病灶发生在贲门的比例明显低于胃癌组，发生在胃底、胃体的比例明显高于胃癌组，差异均有统计学意义（P均＜0.05）；胃淋巴瘤组与胃癌组病灶发生在胃窦的比例差异无统计学意义（P＞0.05）。胃淋巴瘤组SUVmax平均值明显高于胃癌组，差异有统计学意义(P＜0.05)。SUVmax诊断临界值为9.55，约登指数为0.562，鉴别诊断的敏感性为72.9％，特异性为83.3％。胃淋巴瘤组血CEA及CA199升高比例较胃癌组少，差异均有统计学意义(P均＜0.05)。胃淋巴瘤组对脾脏、肠道及胰腺侵犯率明显高于胃癌组，肝脏侵犯率低于胃癌组，差异均有统计学意义(P均＜0.05）。结论:18F-FDG PET/CT检查在鉴别胃淋巴瘤与胃癌中有重要价值，可辅助临床选择治疗方案。

Differential value of 18F-FDG PET/CT imaging between gastric lymphoma and gastric cancer

Objective:To investigate the significance of 18F-FDG PET/CT imaging in the differential diagnosis of gastric lymphoma and gastric cancer.Methods:The clinical data of 48 patients with gastric lymphoma and 66 patients with gastric cancer confirmed by pathology in our hospital from October 2017 to September 2021 were analyzed retrospectively.The age,gender,location of gastric lesions,maximum standardized uptake value(SUVmax) and the results of blood carcinoembryonic antigen(CEA) and blood glucose antigen 199(CA199) and extragastric tissue invasion were statistically analyzed by two independent sample t-test and χ２ inspection.Results:There was no significant difference in gender distribution between gastric lymphoma group and gastric cancer group(P＞0.05).The average age of patients in gastric lymphoma group was significantly younger than that in gastric cancer group(P＜0.05).The proportion of lesions in cardia in gastric lymphoma group was lower than that in gastric cancer group,and the proportion of lesions in gastric fundus and gastric body in gastric lymphoma group was significantly higher than that in gastric cancer group(all P＜0.05).There was no significant difference in the proportion of lesions in gastric antrum between gastric lymphoma group and gastric cancer group(P＞0.05).The average value of SUVmax in gastric lymphoma group was significantly higher than that in gastric cancer group(P＜0.05).The diagnostic threshold of SUVmax was 9.55,the yoden index was 0.562.The sensitivity of differential diagnosis was 72.9% and the specificity was 83.3%.The increase rates of serum CEA and CA199 in gastric lymphoma group were less than those in gastric cancer group(all P＜0.05).The invasion rate of spleen,intestine and pancreas in gastric lymphoma group was significantly higher than that in gastric cancer group,and the invasion rate of liver was lower than that in gastric cancer group(all P＜0.05).Conclusion:18F-FDG PET/CT is of great significance in the differential diagnosis of gastric lymphoma and gastric cancer.