摘要
目的分析全身^(18)F-FDG PET/CT显像病例,识别皮下结节异常图像,探讨PET/CT在发现皮下软组织转移中的临床应用价值及其对生存的影响。方法回顾性分析4500个病例,发现皮下结节^(18)F-FDG显像阳性病例57例,均行病理穿刺或活检证实。搜集患者组织学亚型、转移模式、治疗和生存率。采用Kaplan-Meier曲线估计生存时间,采用Mantel-Cox单因素分析确定广泛转移、软组织受累程度、全身和局部治疗与生存时间的相关性。结果57例中,10例良性,47例恶性。47例恶性肿瘤中,39例为术后病例,8例为手术前,4例原发病灶不明。共发现皮下病灶88处,单一病灶患者28例,2个病灶12例,3个及以上病灶8例。1例原发灶不明患者,以腹壁结节为主诉症状。PET/CT在11例患者中协助明确了病变的性质和位置。单因素分析显示,未接受局部放疗患者的中位生存时间(22个月)明显短于接受局部放疗的患者(60个月)(P<0.05)。性别、转移模式、初始诊断时的转移、使用化疗与生存时间的差异无关。结论全身PET/CT显像在诊断皮下软组织转移中具有重要的应用价值。通过全面评估患者的全身状况,精准判断是否存在单纯的软组织转移,对于一般状况良好且仅有软组织转移的患者,采取局部干预措施可以带来更有利的预后。
Objective To retrospectively analyze cases of whole-body^(18)F-FDG PET/CT imaging,identify abnormal images of subcutaneous nodules,and explore the clinical application value of PET/CT in detecting subcutaneous soft tissue metastases and its impact on survival.Methods A total of 4500 cases from August 2019 to August 2024 were analyzed,and 57 cases with positive^(18)F-FDG imaging of subcutaneous nodules were found,all of which underwent pathological puncture or biopsy.Collect patient histological subtypes,metastasis patterns,treatment,and survival rates.Kaplan-Meier curves were used to estimate survival time,and Mantel-Cox univariate analysis was used to determine the correlation between extensive metastasis,degree of soft tissue involvement,systemic and local treatment,and survival time.Results Among the 57 patients confirmed by pathology,10 were benign and 47 were malignant.Among 47 cases of malignant tumors,39 cases were postoperative cases,8 cases were preoperative cases,and 4 cases had unknown primary lesions.A total of 88 subcutaneous lesions were found,including 28 patients with a single lesion,12 patients with two lesions,and 8 patients with three or more lesions.One patient with unknown primary lesion reported abdominal wall nodules as the main symptom.PET/CT assisted in clarifying the nature and location of the lesions in 11 patients.Univariate analysis showed that the median survival time of patients who did not receive local radiotherapy(22 months)was significantly shorter than that of patients who received local radiotherapy(60 months)(P<0.05).There was no correlation between gender,metastasis pattern,metastasis at initial diagnosis,use of chemotherapy,and survival time.Conclusion Whole body PET/CT imaging has important application value in the diagnosis of subcutaneous soft tissue metastasis.By comprehensively evaluating the patient's overall condition and accurately determining whether there is a simple soft tissue metastasis,local intervention measures can provide more favorable prognosis for patients with good general condition and only soft tissue metastasis.
作者
高宇飞
张晖
郝天成
贾立镯
吴江萌
吴冬雪
吴思奇
王勇
GAO Yufei;ZHANG Hui;HAO Tiancheng(Department of Radiology and Nuclear Medicine,First Hospital of Hebei Medical University,Shijiazhuang,Hebei Province 050000,P.R China)
出处
《临床放射学杂志》
北大核心
2025年第6期1092-1097,共6页
Journal of Clinical Radiology
