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18F-FDG PET/CT最大标准摄取值与中低分化肝细胞肝癌临床病理特征的相关性

Correlations between maximum standardized uptake value in 18F-FDG PET/CT and clinical pathological characteristics of moderately to poorly differentiated hepatocellular carcinoma

    摘要
  • 摘要: 目的：探讨中低分化肝细胞肝癌（hepatocellular carcinoma, HCC）患者行18F-氟代脱氧葡萄糖（fluorine-18 fluorodeoxyglucose,18F-FDG）PET/CT显像的最大标准摄取值（maximum standardized uptake value，SUVmax）与肿瘤病理分化程度、肿瘤大小及Ki-67表达的相关性。方法：回顾性分析187例经手术病理学确诊为肝脏内单发HCC患者的18F-FDG PET/CT影像资料。按肿瘤病理学分化程度分为中分化组、中-低分化组及低分化组；按肿瘤最大径分为≤3 cm、3~5 cm(包括5 cm)、5~10 cm(包括10 cm)、＞10 cm组；按Ki-67表达程度分为高表达组（、、）和低表达组（－、＋）。比较各组间病灶的SUVmax和肿瘤/肝脏本底SUVmax比值（tumor to normal background ratio, TNR）差异，分析SUVmax与肿瘤分化程度、肿瘤最大径及Ki-67表达的相关性。结果：肿瘤中分化组（n=98）、中-低分化组（n=52）及低分化组（n=37）的SUVmax和TNR差异均有统计学意义（P<0.000 1），SUVmax与肿瘤分化程度负相关（r=-0.384 57，P<0.000 1）。肿瘤最大径≤3 cm组（n=70）、3~5 cm组（n=51）、5~10 cm组（n=43）、＞10 cm组（n=23）间SUVmax和TNR差异均有统计学意义（P<0.000 1），SUVmax与肿瘤最大径正相关（r=0.537 27，P<0.000 1）。Ki-67低表达组（n=102）和Ki-67高表达组（n=85）的SUVmax和TNR差异均有统计学意义（P<0.000 1），SUVmax与肿瘤Ki-67表达正相关（r=0.370 96，P<0.000 1）。结论：中低分化HCC行18F-FDG PET/CT显像时，随着分化程度降低、肿瘤增大、Ki-67表达水平升高，SUVmax和TNR值均相应升高。

     

    Abstract: Objective：To investigate the correlations between the maximum standardized uptake value (SUVmax) in fluorodeoxyglucose F18 (18F-FDG) positron emission tomography-computed tomography (PET/CT) with the tumor differentiation, tumor size, and Ki-67 expression in patients with moderately and poorly differentiated hepatocellular carcinoma (HCC). Methods：The 18F-FDG PET/CT imaging data of 187 patients with single HCC lesion confirmed by pathology were evaluated retrospectively. According to the differentiation degree of tumor pathology, the patients were divided into moderate differentiation group, moderate-poor differentiation group, and poor differentiation group. According to the maximum diameter of the tumor, the patients were divided into ≤3 cm, 3-5 cm, 5-10 cm, and >10 cm group. According to the positive rate of Ki-67 expression, the patients were divided into high expression group (, , and ) and low expression group (－ and ＋). The SUVmax of primary tumor and the tumor to normal background ratio (TNR) were compared among groups. Furthermore, the correlations between SUVmax and pathological characteristics of HCC such as the maximum diameter of the tumor, tumor differentiation, and Ki-67 expression were analyzed. Results：The SUVmax and TNR were significantly different among moderate differentiation group (n=98), moderate-poor differentiation group (n=52) and poor differentiation group (n=37, both P<0.000 1), and the SUVmax was significantly correlated with the differentiation degree of tumor cells (r=-0.384 57, P<0.000 1). The maximum tumor diameter ≤3 cm group (n=70), 3-5 cm group (n=51), 5-10 cm group (n=43), and >10 cm group (n=23) had significant differences in SUVmax and TNR (both P<0.000 1), and the SUVmax was significantly correlated with the maximum tumor diameter (r=0.537 27, P<0.000 1). The SUVmax and TNR were both significantly different between Ki-67 low expression group (n=102) and Ki-67 high expression group (n=85, both P<0.000 1), and the SUVmax was significantly correlated with the expression of Ki-67 (r=0.370 96, P<0.000 1). Conclusions：In patients with moderately to poorly differentiated HCC, the SUVmax and TNR in 18F-FDG PET/CT are significantly associated with poor differentiation, large tumor size, and high expression of Ki-67.

     

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