摘要
目的探讨18F-FDGPET／CT在肾细胞癌（RCC）并发静脉癌栓患者的肿瘤分期和癌栓分级中的应用价值。方法回顾性分析2011年12月至2015年9月行全身18F-FDGPET／CT检查被诊断为RCC，并最终通过手术、病理或随访证实的72例患者（男52例，女20例，年龄36-74岁）的PET／CT、增强cT资料。采用美国Mayo医学中心的5级分类法，对其中诊断为RCC合并静脉癌栓患者的癌栓进行分级，并采用Wilcoxon等级资料秩和检验，分析PET／CT和增强cT对并发静脉癌栓患者的癌栓分级诊断的差异。对所有患者的腹部区层面作NM分期，并用X2检验比较2种检查方法在评价72例患者腹部区层面淋巴结转移和远端转移的差异。结果72例中18例患者发现静脉癌栓，18F-FDGPET／CT显像示癌栓局限在同侧肾静脉内（0级，9例），癌栓延伸至下腔静脉内（I级4例，Ⅱ级2例，Ⅲ级1例），癌栓延伸至膈肌上（Ⅳ级，2例）。72例患者腹部区层面PET／CT分期情况：N0M0期20例，N1M0期21例，N0M1期9例，N1M2期22例；增强cT分期情况：NoM0期50例，N1M0期10例，N0M1期10例，N1M1期2例。除腹部区平面外，全身PET／CT另发现淋巴结转移（N1）和远端转移（M1）各2例。18F-FDGPET／CT在癌栓分级及腹部区层面NM分期上优于增强CT（z=-2．462，P〈O．05；x=32．806，P〈0．01）。结论18F-FDGPET／CT检查不仅可以了解RCC合并静脉癌栓患者的局部和全身转移情况，还能明确癌栓的延伸范围，对癌栓进行准确分级，其诊断效能优于增强CT，能够帮助临床确定最佳治疗方案，改善患者预后。
Objective To investigate the value of lSF-FDG PET/CT in the phasing and grading of renal cell carcinoma （RCC） complicated with vena cava tumor thrombus （~CTT）. Methods From De- cember 2011 to September 2015, a total of 72 patients （ 52 males, 20 females, age ： 36-74 years） were enrolled in this retrospectively study. All patients underwent lSF-FDG PET/CT and contrast-enhanced CT stud- ies, and were diagnosed as RCC. The RCC patients combined with VCTT were classified by Mayo-level. Wilcoxon rank sum test was used to compare the grading of VCTT by PET/CT and contrast-enhanced CT. NM staging on abdominal area level was performed and the results were compared with X2 test. Results VCTT was identified in 18 RCC patients and the grading resuhs by PET/CT were as follows： 9 cases in Lev- el 0, 4 cases in Level I , 2 cases in Level II , I case in Level m, and 2 cases in Level IV. When evalua- ted by PET/CT, 20 cases were in NoM0, 21 were in NIMo, 9 were in NoMI, and 22 were in N1M1. NM staging results by contrast-enhanced CT were as follows： 50 cases in NoMo, 10 in N1M0, 10 in N0M1, and 2 in N1M1. In addition, 2 N1 and 2 M1 were found by the whole body PET/CT. The classification results of VCTF and staging of abdominal level by PET/CT were significantly better than those by contrast-enhanced CT （z=-2.462, P〈0.05;X2=32.806, P〈0.01）. Conclusion 18F-FDG PET/CT is not only valuable for detecting primary RCC and local metastasis, but also useful for finding where the VCTT extends, which is conducive to therapeutic planning and further clinical treatment.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2016年第4期310-314,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金（81101067）
作者简介
通信作者：孙龙，Email：13178352662@163.com
