中华临床医师杂志（电子版） 2010年8月,4卷8期

论　著

消化系统肿瘤FDG PET/CT显像标准摄取值与分子生物学的相关性

欧阳林，周丽娟，时昭胤，杨赞军，刘威宏，寿元苗

欧阳林、周丽娟、时昭胤、杨赞军、刘威宏、寿元苗，福建漳州 解放军第175医院(厦门大学附属东南医院)影像科，363000

摘要:目的　探讨消化系统肿瘤PET/CT显像FDG标准摄取值(SUV)与其分子生物学行为的相关性。方法　回顾性分析资料完整的24例消化系统肿瘤患者PET/CT、手术和病理资料，分析患者PET/CT显像FDG摄取指数SUV值与癌肿浸润深度、转移状况之间的相关性以及与肿瘤增殖因子Ki-67、癌基因p53、癌基因C-erbB-2表达的相关性。结果　24例消化系统肿瘤患者SUV值最低为2.5，最高为12，平均值6.34±2.54，按SUV值高低将患者病变均分为低代谢和高代谢两组，低代谢组SUV均值4.39±1.31，高代谢组SUV均值8.48±1.38，两组间SUV值均数差异有统计学意义(t＝2.418，P＜0.05)，两组间病变浸润深度差异无统计学意义(χ2＝0，P＞0.05)，两组间病变邻近淋巴结转移发生率无统计学意义(χ2＝0.686，P＞0.05)。24例患者病变Ki-67值最低为20%，最高为65%，平均值(41±11)%。SUV值与Ki-67值相关性无统计学意义(r＝－0.22，P＞0.05)。低代谢组和高代谢组Ki-67值分别为(43±13)%和(38±9)%，组间差异无统计学意义(t＝0.225，P＞0.05)。低代谢组和高代谢组p53阳性表达例数差异无统计学意义(χ2＝0.711，P＞0.05)。低代谢组和高代谢组C-erbB-2阳性表达例数差异无统计学意义(χ2＝0.686，P＞0.05)。结论　消化系统肿瘤PET/CT显像FDG摄取指数SUV值变异较大，与癌肿浸润深度和邻近淋巴结有无转移之间没有相关性，与肿瘤增殖因子Ki-67、癌基因p53及C-erbB-2表达程度无显著相关性。

关键词:消化系统肿瘤；　正电子发射断层显像术；　病理学；　分子生物学

The association of FDG-PET/CT SUV with molecular biology in digestive canal cancer

OUYANG Lin，ZHOU Li-juan，SHI Zhao-yin，YANG Zan-jun，LIU Wei-hong，SHOU Yuan-miao.

Image Department of 175 Hospital (Affiliated Hospital of Xiamen University Medical College)，Zhangzhou 363000，China

Abstract:Objective　To investigate the association of FDG uptake index of digestive canal cancer PET image with molecular biological behaviour.Methods　Twenty-four patients with digestive canal cancer with complete PET/CT，surgical operation and pathology data were enrolled.Retrospectivly analyzed the correlation between FDG uptake index( SUV value) and cancer infiltration，and lymph node metastasis and Ki-67，p53，C-erbB-2 expression.Results　The FDG uptake index SUV value of 24 subjects，the lowest was 2.5，the highest was 12，the average was 6.34±2.54，were divided equally into hypometabolism group and hypermetabolism group，hypometabolism group average SUV was 4.39±1.31，hypermetabolism group average SUV was 8.48±1.38，the discrepance of SUV average value between two groups had statistical significance(t＝2.418，P＜0.05)，the discrepance of cancer infiltrating depth had no statistical significance(χ2＝0，P＞0.05)，the discrepance of incidence of lymphaden metastasis had no statistical significance(χ2＝0.686，P＞0.05).The Ki-67 value of 24 subjects，the lowest was 20%，the highest was 65%，the average was (41±11)%.The associativity of SUV value and Ki-67 value had no statistical significance(r＝－0.22，P＞0.05).The Ki-67 value of hypometabolism and hypermetabolism were (43±13)% and (38±9)% respectively，the discrepance of two groups had no statistical significance(t＝0.225，P＞0.05).The discrepance of p53 positive cases of hypometabolism and hypermetabolism had no statistical significance(χ2＝0.711，P＞0.05).The discrepance of C-erbB-2 positive cases of hypometabolism and hypermetabolism had no statistical significance(χ2＝0.686，P＞0.05).Conclusions　The SUV of digestive canal cancer PET image 18F-FDG standard uptake value had comparatively large variation，had no significant associativity with cancer infiltrating depth and neighbourhood lymphaden metastases，had no significant associativity with the expression of tumor multiplication factor Ki-67， oncogene p53 and C-erbB-2.

Keywords:Digestive system neoplasms；　Positron-emission tomography；　Pathology；Molecular biology

+ 字体 -

参考文献

[1]　欧阳林，刘士远，肖湘生.肠周脂肪CT征象在诊断肠疾病中的临床价值.中国医学影像技术杂志，2009,25(3)：90-92.
[2]　Al-Sarraf N，Gately K，Lucey J，et al.Clinical implication and prognostic significance of standardised uptake value of primary non-small cell lung cancer on positron emission tomography：analysis of 176 cases.Eur J Cardiothorac Surg,2008,34(4)：892-897.[PubMed]
[3]　Cascini GL，Avallone A，Delrio P，et al. 18F-FDG PET is an early predictor of pathologic tumor response to preoperative radiochemotherapy in locally advanced rectal cancer.J Nucl Med,2006,47(8)：1241-1248.[PubMed]
[4]　Geus-Oei LF，Oyen WJ.Predictive and prognostic value of FDG-PET.Cancer Imaging,2008,8：70-80.[PubMed]
[5]　Eschmann SM，Friedel G，Paulsen F，et al.18F-FDG PET for assessment of therapy response and preoperative re-evaluation after neoadjuvant radio-chemotherapy in stage III non-small cell lung cancer.Eur J Nucl Med Mol Imaging,2007,34(4)：463-471.[PubMed]
[6]　De Leyn P， Stroobants S， De Wever W， et al. Prospective comparative study of integrated positron emission tomography-computed tomography scan compared with remediastinoscopy in the assessment of residual mediastinal lymph node disease after induction chemotherapy for mediastinoscopy-proven stage ⅢA-N2 Non-small-cell lung cancer：a Leuven Lung Cancer Group Study.J Clin Oncol,2006,24(21)：3333-3339.[PubMed]
[7]　Buchmann I，Ganten TM，Haberkorn U.[18F]-FDG-PET in the diagnostics of gastrointestinal tumors.Z Gastroenterol,2008,46(4)：367-375.[PubMed]
[8]　Saga T，Nakamoto Y，Higashi T，et al.Positron emission tomography for the diagnosis and management of patients with gastrointestinal malignancies.Gastrointest Endosc Clin N Am,2008,18(3)：479-493，ix.[PubMed]
[9]　Shin SS， Jeong YY， Min JJ，Preoperative staging of colorectal cancer：CT vs.integrated FDG PET/CT.Abdom Imaging,2008,33(3)：270-277.[PubMed]
[10]　de Geus-Oei LF，Ruers TJ，Punt CJ，et al.FDG-PET in colorectal cancer.Cancer Imaging,2006,6：S71-81.[PubMed]
[11]　de Geus-Oei LF，Vriens D，van Laarhoven HW，et al.Monitoring and predicting response to therapy with 18F-FDG PET in colorectal cancer：a systematic review.J Nucl Med,2009,50 Suppl 1：43S-54S.[PubMed]
[12]　Konski AA，Cheng JD，Goldberg M，et al.Correlation of molecular response as measured by 18-FDG positron emission tomography with outcome after chemoradiotherapy in patients with esophageal carcinoma.Int J Radiat Oncol Biol Phys,2007,69(2)：358-363.[PubMed]
[13]　Larson SM，Schoder H，Yeung H.Positron emission tomography/computerized tomography functional imaging of esophageal and colorectal cancer.Cancer J,2004,10(4)：243-250.[PubMed]
[14]　Wieder HA，Herrmann K，Ott K，et al.18F-FDG-PET in therapy response of esophageal cancer.Radiologe,2007,47(2)：110-114.[PubMed]
[15]　Higuchi I，Yasuda T，Yano M，et al.Lack of fludeoxyglucose F 18 uptake in posttreatment positron emission tomography as a significant predictor of survival after subsequent surgery in multimodality treatment for patients with locally advanced esophageal squamous cell carcinoma.J Thorac Cardiovasc Surg,2008,136(1)：205-212.[PubMed]
[16]　Levine EA， Farmer MR，Clark P，et al.Predictive value of 18-fluoro-deoxy-glucose-positron emission tomography (18F-FDG-PET) in the identification of responders to chemoradiation therapy for the treatment of locally advanced esophageal cancer.Ann Surg,2006,243(4)：472-478.[PubMed]
[17]　Hong D，Lunagomez S，Kim EE，et al.Value of baseline positron emission tomography for predicting overall survival in patient with nonmetastatic esophageal or gastroesophageal junction carcinoma.Cancer,2005,104(8)：1620-1626.[PubMed]
[18]　顾国利，魏学明，王石林，等.胃癌组织中CEA、p53、nm23、Ki-67、MRP表达及意义.中国老年学杂志，2007,27(12)：2414-2416.
[19]　孙金利，刘东举，于玲，等.大肠癌组织P53异常表达与预后因素相关性研究.辽宁医学杂志，2008,22(2)：81-82.
[20]　惠延平，董高升，文亮.ras、c-erbB-2癌基因蛋白在胃癌及癌旁组织中的表达及分布特征.诊断病理学杂志，2001,8(3)：163-165.
[21]　Gillham CM，Lucey JA，Keogan M，et al.(18)FDG uptake during induction chemoradiation for oesophageal cancer fails to predict histomorphological tumour response.Br J Cancer,2006,95(9)：1174-1179.[PubMed]
[22]　Schmidt M，Bollschweiler E，Dietlein M，et al.Mean and maximum standardized uptake values in [18F]FDG-PET for assessment of histopathological response in oesophageal squamous cell carcinoma or adenocarcinoma after radiochemotherapy.Eur J Nucl Med Mol Imaging,2009,36(5)：735-744.[PubMed]
[23]　Suttie SA，Welch AE，Park KG.Positron emission tomography for monitoring response to neoadjuvant therapy in patients with oesophageal and gastro-oesophageal junction carcinoma.Eur J Surg Oncol,2009,35(10)：1019-1029.[PubMed]
[24]　Rebollo Aguirre AC，Ramos-Font C， Villegas Portero R， et al. 18F-fluorodeoxiglucose positron emission tomography for the evaluation of neoadjuvant therapy response in esophageal cancer：systematic review of the literature.Ann Surg,2009,250(2)：247-254.[PubMed]
(编辑：吴莹 收稿日期：2009-04-01)