胃癌18F-FDG PET/CT影像学表现与临床病理的相关性研究

目的 探讨胃癌18F-氟脱氧葡萄糖（FDG） PET/CT影像学表现与临床病理的相关性。 方法 回顾性分析2011年10月至2016年6月在福建省肿瘤医院行PET/CT检查并接受手术治疗的101例胃癌患者的临床病理资料，其中男性73例、女性28例，年龄25~81（59.74±11.39）岁。分析PET/CT原发灶的最大标准化摄取值（SUV_max）、厚度及淋巴结转移等情况，以性别、年龄、原发灶部位、原发灶长径、病理类型及分化程度、TNM（肿瘤、结节、转移）分期及临床分期为分组条件，采用独立样本t检验、单因素方差分析评价各组间SUV_max的差异，采用Pearson相关性分析评价SUV_max与原发灶大小之间的关系。筛选有统计学差异的指标纳入多因素Logistic回归分析，评价淋巴结转移与各因素之间的关系。 结果 101例胃癌患者原发灶的SUV_max在原发灶长径D（<4 cm:3.774±1.062，4 cm≤D<8 cm:6.552±3.695，≥8 cm:5.592±2.305）、原发灶部位（胃底及贲门:7.157±4.425，胃体:4.710±2.010，胃窦:6.137±3.069）和病理类型（印戒细胞癌:4.176±1.724，非印戒细胞癌:5.998±3.295）组间的差异有统计学意义（t=7.022, P=0.001；t=5.564，P=0.005；t=2.212，P=0.029）。Pearson 相关性分析结果表明，SUV_max与胃癌原发灶的长径、短径、厚度呈正相关（r=0.209，P=0.036；r=0.245，P=0.013；r=0.359，P<0.001）。PET/CT诊断胃癌淋巴结转移的灵敏度、特异度、准确率分别为71.3%（57/80）、81.0%（17/21）、73.3%（74/101）。多因素Logistic回归分析结果表明，T分期是淋巴结是否转移的独立相关因素（OR=12.648，95%CI:3.905~40.961， P<0.001）。 结论 胃癌原发灶SUV_max与肿瘤大小、部位、病理类型有关，T分期是预测淋巴结转移的独立因素。

Correlative studies between 18F-FDG PET/CT findings and pathology of gastric cancer

Objective To investigate the correlation between findings from 18F-fluorodeoxyglucose (FDG) PET/CT and pathology of gastric cancer. Methods A retrospective analysis was performed on data collected from 101 patients with gastric cancer, including 73 males and 28 females, aged 25?81 ( 59.74±11.39) years old, who underwent PET/CT examination and surgical treatment in Fujian Provincial Cancer Hospital from October 2011 to June 2016. Maximum standardized uptake value (SUV_max) in primary lesion, thickness of primary lesions, and lymph node metastasis in PET/CT were recorded. According to gender, age, location of primary lesion, length of primary lesion, pathological type and differentiation degree of primary lesion, TNM (tumor, node, metastasis) stage and clinical stage. Independent sample t test and one-way ANOVA were used to evaluate the difference in SUV_max between each group. Pearson correlation analysis was employed to examine the relationship between SUV_max and the size of primary lesion. Indices with statistical differences were included in multivariate Logistic regression analysis to evaluate the relationship between lymph node metastasis and each factor. Results Difference of SUV_max in length (<4 cm: 3.774±1.062, 4 cm≤D<8 cm: 6.552±3.695, ≥8 cm: 5.592±2.305), location (gastric fundus and cardia: 7.157±4.425, gastric body: 4.710±2.010, gastric antrum: 6.137±3.069), and pathological type of gastric cancer (signet ring cell carcinoma: 4.176±1.724, non-signet ring cell carcinoma: 5.998±3.295) were statistically significant (t=7.022, P=0.001; t=5.564, P=0.005; t=2.212, P=0.029). The results of Pearson correlation analysis showed that SUV_max was positively correlated with the length, width and thickness of gastric cancer (r=0.209, P=0.036; r=0.245, P=0.013; r=0.359, P<0.001). The sensitivity, specificity and accuracy of PET/CT in the diagnosis of lymph node metastasis of gastric cancer were 71.3% (57/80), 81.0% (17/21) and 73.3% (74/101), respectively. The result of multivariate Logistic regression analysis showed that T stage is an independent correlation factor for lymph node metastasis (OR=12.648, 95%CI=3.905?40.961, P<0.001). Conclusions The SUV_max of primary gastric cancer lesion is related to size, location, and pathological type. T stage is an independent predictor of lymph node metastasis.