摘要
目的评价18F—FDGPET／CT在Castleman病（CD）的临床分型、疗效评价及转化监测中的应用价值。方法回顾性分析14例CD患者[年龄（45．64±14．30）岁，男、女各7例]的18F—FDGPET／CT影像表现（病灶数量、分布、SUVmax），比较不同临床分型、病理类型、病理转化患者的影像表现，并对4例化疗后复查18F—FDGPET／CT患者的病灶影像学变化进行记录。数据比较采用Mann—Whitney及Kmskal—Wallis秩和检验。结果12例病理未发生转化的CD患者，化疗前18F—FDGPET／CT检查均有1个或多个淋巴结肿大且伴有葡萄糖代谢增高，SUVmax 3．94±1．44（1．9～6．8）；临床类型为单中心（2／12）与多中心（10／12）CD的SUVmax分别为4．55±3．18和3．82±1．14，差异无统计学意义（Z=0．22，P〉0．05）；病理类型分别为透明血管型（4／12）、浆细胞型（6／12）、混合型（2／12）CD的SUVmax分别为3．56±0．96、4．73±1．41和2．30±0．57，差异无统计学意义（X^2=4．74，P〉0．05）。4例（4／12）化疗后复查PET／CT的患者中，3例病灶完全消失，1例病灶缩小、代谢减低。2例（2／14）发生病理转化的患者，SUVmax 10．85±2．05，高于未转化者（3．94±1．44；Z=-2．19，P〈0．05）。结论^18F—FDGPET／CT对于指导CD的临床分型、评价化疗疗效和监测病理转化均有一定的应用价值。
Objective To assess the value of 18F-FDG PET/CT in clinical classification, monitoring of chemotherapeutic response and surveillance of histopathologieal transformation of Castleman＇s disease （CD）. Methods Fourteen pathologically diagnosed CD patients （7 males, 7 fermales; mean age： （45.64± 14. 30） years） were retrospectively reviewed, 18F-FDG PET/CT was performed before chemotherapy in all patients and 4 of 14 patients were reexamined after the treatment. The study parameters included histopathological results, sites, number and highest SUV of the lesions. Mann-Whitney and Kruskal-Wallis tests were used for data analysis. Results Of all the 12 patients without histopathological transformation, one or more enlarged and metabolically active lymph nodes were found in each patient（ SUVmax = 3.94±1.44, range： 1.9- 6. 8） , including 2 unieentric CD （UCD） and 10 multicentric CD （MCD）. There was no statistically significant difference of SUV between UCD and MCD （4.55±3.18 vs 3.82±1.14; Z= 0.22, P〉0. 05）. There was also no significant difference of SUV among different pathological types （hyaline-vascular CD （4/12） ： 3.56±0. 96, plasma cell CD （6/12） ： 4.73±1.41, mixed CD （2/12） ： 2.30±0.57; X2 =4.74, P〉0.05）. For the 4 patients with follow-up PET/CT after chemotherapy, the lesion activity was normalized in 3 patients and clearly reduced in 1 patient. The SUVmax of 2 patients with histopathological transformation （ 10.85± 2.05） was significantly higher than that without transformation （ 3.94± 1.44 ; Z= -2.19, P〈0.05）. Conclusion 18F-FDG PET/CT may play an important role in clinical classification, monitoring of chemotherapeutic response and surveillance of histopathological transformation of CD.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2013年第5期332-335,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
