Relation Between Metabolic Parameters of 18F-FDG PET/CT and Clinicopathological Features of Colorectal Cancer Patients
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摘要:目的
探讨18F-FDG PET/CT代谢参数与结直肠癌临床病理特征的关系。
方法纳入358例CRC患者行治疗前18F-FDG PET/CT显像，测量CRC原发灶最大标准摄取值、平均标准摄取值、肿瘤代谢体积和病灶糖酵解总量，分析其与原发灶位置、病理特征及TNM分期的关系。
结果结肠癌原发灶MTV及TLG值最高，乙状结肠癌次之，直肠癌最低，组间差异有统计学意义（P < 0.001）。低/中低分化直肠癌SUVmax值高于中/高分化直肠癌（P=0.028）。黏液腺癌原发灶MTV值较普通型腺癌大（P=0.023）。T4期原发灶MTV和TLG值高于T2-3期病灶（P=0.0001, P=0.007）。存在远处转移的乙状结肠癌原发灶SUVmax及SUVmean低于无远处转移者（P=0.015, P=0.011）。
结论CRC原发灶代谢参数与位置、病理特征及TNM分期相关，能部分反映肿瘤病理特征，揭示CRC异质性。
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关键词:
- 结直肠癌 /
- 正电子发射计算机断层显像 /
- 代谢参数 /
- 临床病理特征
Abstract:ObjectiveTo investigate the relation between 18F-FDG PET/CT metabolic parameters and the clinicopathological characteristics of colorectal cancer (CRC) patients.
MethodsWe included 358 CRC patients who met the admission criteria. 18F-FDG PET/CT scans were performed before any treatment. Maximum standard uptake, average standard uptake, tumor metabolic volume (MTV) and total glycolysis (TLG) of the primary lesion of CRC were measured and calculated. The correlation of metabolic parameters with lesion location, pathological profile and TNM staging were investigated through Mann-Whitney U test and Kruskal-Wallis test.
ResultsThe MTV and TLG values in the primary foci of colon cancer were the highest, followed by sigmoid cancer and the lowest in rectal cancer, with statistically significant differences between the groups (P < 0.001). SUVmax values of poorly/poorly-moderately differentiated colorectal cancer were higher than those of moderately/well differentiated colorectal cancer (P=0.028). MTV values of primary mucinous adenocarcinoma were higher than those of primary adenocarcinoma (P=0.023). MTV and TLG values were higher in T4 lesions than those in T2-3 lesions (P=0.0001, P=0.007); SUVmax and SUVmean values of sigmoid carcinoma with distant metastasis were lower than those without distant metastasis(P=0.015, P=0.011).
ConclusionThe metabolic parameters of CRC are correlated with the lesion location, pathological features and TNM staging, which could partly reflect the pathological characteristics and heterogeneity of CRC.
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作者贡献宋金龄：数据收集、统计及文章撰写李忠武：病理及免疫组织化学诊断卫毛毛：数据收集周妮娜：数据统计杨志：PET/CT扫描质控及数据校对王雪鹃：数据校对及文章修改
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图 1 结肠癌、乙状结肠癌及直肠癌原发灶的肿瘤负荷常数
Figure 1 Tumor load constant of primary lesions of colon cancer, sigmoid cancer and rectal cancer
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图 2 左右半结肠原发灶的肿瘤负荷常数
Figure 2 Tumor load constant of primary lesions of left and right hemicolon
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图 3 直肠癌分化程度与SUVmax值的关系
Figure 3 Relation between differentiation and SUVmax of rectal cancer
表 1 358例结直肠癌患者基本临床病理特征(n(%))
Table 1 Clinicopathologic features of 358 colorectal cancer (CRC) patients (n(%))
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表 2 原发灶代谢参数与分化程度及Ki-67表达的关系
Table 2 Correlation of primary metabolic parameters with differentiation and Ki-67 expression
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