三种类型肺癌18氟脱氧葡萄糖摄取量的初步研究

目的探讨肺鳞癌、腺癌、细支气管肺泡癌对18氟脱氧葡萄糖(fluorine -18 fluorode～oxyglucose,FDG)摄取的差异以及影响肺癌摄取FDG的常见因素. 方法对82例肺癌患者行全身或肺部正电子发射体层显像(positron emission tomography,PET)检查,测定肿瘤组织FDG的标准摄取值(standard uptake value,SUV)、最大与平均标准摄取值(SUVmax、SUVmean)、正常肺组织的SUV(SUVlung). 结果 82例患者中,肿瘤组织对FDG的摄取能力均高于相应的正常肺组织(P＜0.01).肺鳞癌、腺癌、细支气管肺泡癌的SUVmax分别为8.42±4.05,5.91±3.91和 2.97±1.10;SUVmean 分别为6.12±2.90,4.35±3.10和 2.25±0.99,三者差异有显著性意义(P＜0.01).SUV与肿瘤的大小呈正相关(P＜0.01).血糖水平与正常肺组织的SUV对肿瘤的SUV有影响(P＜0.05).结论 (1)肺癌组织对FDG的摄取能力高于正常肺组织,而且不同组织类型的肺癌之间SUV值差异有显著性意义.(2)肿瘤的大小与FDG摄取量存在着正相关性.(3)临床上解释肺癌患者PET检查结果时应考虑到血糖等因素的影响.

Fluorine-18 fluorodeoxyglucose uptake in patients with primary lung cancer

OBJECTIVE: To assess the relationship between histological type and fluorine-18 fluorodeoxyglucose(FDG) uptake in patients with primary lung cancer and the factors affecting FDG uptake. METHODS: From October 1998 to April 2001, 82 patients with lung cancer were imaged with FDG-PET (Positron emission tomography) before surgery or biopsy. Their maximum and mean standard uptake value(SUVmax and SUVmean) of tumor and SUV of normal lung (SUVlung) were measured. RESULTS: All tumors were detected by FDG-PET(r)FDG uptake of tumor was higher than that of normal lung (P < 0.01). FDG uptake was lower in adenocarcinoma(AC) than in squamous cell carcinoma (SQC), and that of bronchial aveolar carcinomas(BAC) was the lowest [SUVmax was 8.42 +/- 4.05,5.91 +/- 3.91 and 2.97 +/- 1.10, respectively; SUVmean was 6.12 +/- 2.90,4.35+/- 3.10 and 2.25 +/- 0.99, respectively (P < 0.01)]. Correlations were found between FDG uptake and tumor size (P < 0.01)(r)Glucose level and SUV of normal lung could affect SUV of lung cancer (P < 0.05). CONCLUSIONS: SUV is higher in cancer tissue than in normal lung tissue. FDG uptake is different among SQC,AC and BAC. FDG uptake and tumor size appear to be correlated with each other.SQC, AC and BAC have their own features respectively.The effects of glucose and SUV lung should be considered in the diagnosis of lung cancer with PET.