^18F-FDG符合线路显像最大标准摄取值在胃癌评估中的价值

目的研究^18F—FDG符合线路显像SUVmax在胃癌评估中的意义。方法回顾性分析92例胃部疾病患者[男60例，女32例，平均年龄65（32～85）岁；其中胃癌78例]。78例胃癌中，残胃癌3例、原发性胃癌75例（Eis期4例、T1期13例、T2期9例、T3期33例、T4期11例，5例未手术）；高分化腺癌22例，中分化腺癌15例，低分化腺癌28例。采用ROI技术分析图像并计算SUVmax，分别用视觉法与SUVmax分析^18F—FDG符合线路显像资料，并以组织病理学或活组织检查结果为标准计算两者检验效能。使用ROC曲线分析评价SUVmax；采用Pearson相关分析评估SUVmax与病灶大小的关系，Wilcoxon秩和检验分析SUVmax在进展期胃癌和早期胃癌的差异，Kruskal—Wallis检验分析SUVmax与不同分化程度腺癌的关系。结果^18F—FDG符合线路显像视觉法与SUVmax诊断胃癌的灵敏度均为64．1％（50／78），特异性均为64．3％（9／14），准确性均为64．1％（59／92）。SUVmax ROCAUC为0．695，最佳临界值为0．700；SUVmax与病灶最大径呈正相关（r=0．489，P〈0．001），Tis-1期病灶SUVmax（0．676±1．288）与L～4期SUVmax（3．851±3．764）差异有统计学意义（Z=-3．754，P〈0．001），而高、中、低分化腺癌间SUVmax（分别为2．805±4．008，3．447±2．365，3．413±3．737）差异无统计学意义（X2=2．459，P〉0．05）。结论在^18F-FDG符合线路显像评估胃癌中，SUVmax较视觉法提供了更多的信息，但其与胃癌T分期、组织学类型、分化程度等的关系需进一步研究。

Analysis of ^18F-FDG maximum standardized uptake value in gastric cancer with coincidence imaging

Objective To investigate the value of ^18F-FDG SUVmax in gastric cancer diagnosis with coincidence imaging. Methods The coincidence imaging was performed in 92 patients with gastric diseases （60 males, 32 females, age 65 （32-85） years; 78 malignant cases, 14 benign cases）. The malignant cases included 3 remnant gastric cancers and 75 primary gastric cancers （ staging： 4 of Tis, 13 of T1, 9 of T2, 33 of T3, 11 of T4 and 5 without surgery）. The well-, moderately- and poorly-differentiated adenocarcinomas were 22, 15 and 28, respectively. Images were analyzed retrospectively with visual method and 18F-FDG SUV and the diagnostic results were compared with the histopathological findings. The ROC curve was used to analyze the SUVmax. The Pearson＇s correlation analysis was performed to evaluate the relationship be- tween SUVmax and tumor size. The Wileoxon rank sum test was applied to determine the difference of SUVmax between early and advanced gastric cancers. The Kruskal-Wallis test was used to analyze the difference of SUVmax in various types of differentiated adenoearcinoma. Results No matter visual method or SUVmax was used, the sensitivity, specificity and accuracy of coincidence imaging in diagnosis of gastric cancer were 64. 1% （50/78） , 64.3% （9/14） and 64.1% （59/92） , respectively. The AUC of SUVmax was 0.695 and the cut-off value was 0.700. SUVmax was positively correlated with tumor size significantly（ r-0.489, P〈0.001 ）. There was statistically significant difference between SUVmax of Tis-1 and that of T2-4（ 0.676± 1.288 vs 3.851±3.764;Z=-3.754, P〈0.001 ）. However, there was no statistically significant difference among SUV of various grades of differentiated adenocareinoma（ 2.805±4.008,3.447±2.365,3.413±3.737;x2= 2.459, P〉 0.05）. Conclusions SUVmax provides more information than visual method in assessing gastric cancer with ^18F-FDG eoineidenee imaging. Appropriate cut-off value of SUV is necessary for improvement of the diagnostic effieieney. Relationships between SUV and pathological T stage, histopathologieal types and differentiation degree need further investigation.