基于18F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测

doi:10.3969/j.issn.1006-7795.2022.06.003

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (6): 834-839.doi: 10.3969/j.issn.1006-7795.2022.06.003

• 核医学与分子影像辅助临床诊疗 • 上一篇下一篇

基于¹⁸F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测

张丽¹, 李兵², 童冠圣^1*

1.首都医科大学附属北京世纪坛医院核医学科, 北京 100038;
2.首都医科大学附属北京世纪坛医院腹膜肿瘤外科, 北京 100038

收稿日期:2022-09-30 出版日期:2022-12-21 发布日期:2022-11-30
基金资助:
国家自然科学基金面上项目(82073376)。

Prediction of tumor histopathological grade using a modified peritoneal cancer index by ¹⁸F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei

Zhang Li¹, Li Bing², Tong Guansheng^1*

1. Department of Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038,China,
2. Department of Peritoneal Cancer Surgery,Beijing Shijitan Hospital, Capital Medical University, Beijing 100038,China

Received:2022-09-30 Online:2022-12-21 Published:2022-11-30
Contact: ^*E-mail:tgseng@163.com

摘要/Abstract

摘要： 目的本研究将探讨基于氟-18-脱氧葡萄糖(¹⁸F-fluorodeoxyglucose,¹⁸F-FDG)正电子发射型计算机断层显像/电子计算机断层显像(positron emission tomography/computed tomography,PET/CT) 的改良PET-腹膜癌指数(peritoneal cancer index,PCI)、最大标准化摄取值(maximum standardized uptake value,SUVmax)与最大标准化摄取值/肝脏平均标准化摄取值(SUVmax/ liver mean standardized uptake value, SUVmax/SUVmean_liver)预测腹膜假黏液瘤(pseudomyxoma peritonei,PMP)组织病理学分级的能力。方法回顾性分析2017年1月至2022年6月间31例阑尾来源PMP患者的临床病理学数据及34例次(3名患者行2次检查)¹⁸F-FDG PET/CT检查结果。将13个特定腹盆区域PMP病灶的SUVmax评分汇总得到PET-PCI。同时还测量了腹盆腔病灶的SUVmax与SUVmax/SUVmean_liver。结果低级别PMP患者14例、高级别PMP患者12例、高级别伴印戒细胞PMP患者5例。高级别PMP患者的PET-PCI、SUVmax和SUVmax/SUVmean_liver值均高于低级别PMP患者(PET-PCI: 23.08±7.47 vs 15.81±10.59,P=0.047; SUVmax:7.91±4.67 vs 6.73±3.99,P=0.470;SUVmax/SUVmean_liver:3.63±1.89 vs 3.17±2.70,P=0.614)。高级别伴印戒细胞PMP患者的 PET-PCI、SUVmax及SUVmax/SUVmean_liver值均高于高级别PMP患者(PET-PCI:25.20±8.84 vs 23.08±7.47,P=0.614; SUVmax:9.29±8.46 vs 7.91±4.67,P=0.660;SUVmax/SUVmean_liver:3.73±1.83 vs 3.63±1.89,P=0.917)。PET-PCI、SUVmax及SUVmax/SUVmean_liver值的高低与PMP分级一致,但只有高级别PMP患者的PET-PCI与低级别PMP患者之间的差异有统计学意义。结论与SUVmax及SUVmax/SUVmean_liver相比,PET-PCI能更好地反映PMP患者的组织病理学分级。

关键词: 氟-18-脱氧葡萄糖, 正电子发射型计算机断层显像, 腹膜假黏液瘤 , 组织病理学分级

Abstract: Objective The aim of this study was to investigate the ability of the modified peritoneal cancer index (PCI) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT), maximum standardized uptake value (SUVmax) and SUVmax/liver mean standardized uptake value(SUVmean_liver) to predict the histopathological grade in patients with pseudomyxoma peritonei(PMP). Methods The pathological data of 31 patients with PMP of appendiceal origin and 34 ¹⁸F-FDG PET/CT results (3 patients underwent twice examinations) from January 2017 to June 2022 were analyzed retrospectively. PET-PCI was the sum of the SUVmax scores of PMP lesions in 13 specific abdominal-pelvic regions. The SUVmax and SUVmax/SUVmean_liver of the lesion were also measured. Results There were 14 cases of low grade PMP, 12 cases of high grade PMP, and 5 cases of high grade with signet ring cells PMP. The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade were higher than those of the low grade (PET-PCI:23.08 ± 7.47 vs 15.81 ± 10.59, P=0.047; SUVmax:7.91 ± 4.67 vs 6.73 ± 3.99, P=0.470; SUVmax/SUVmean_liver:3.63 ± 1.89 vs 3.17 ± 2.70, P=0.614). The PET-PCI, SUVmax and SUVmax/SUVmean_liver values of the high grade with signet ring cells were higher than those of the high grade (PET-PCI:25.20 ± 8.84 vs 23.08 ± 7.47, P=0.614; SUVmax:9.29 ± 8.46 vs 7.91 ± 4.67, P=0.660;SUVmax/SUVmean_liver:3.73±1.83 vs 3.63±1.89,P=0.917)。The values of PET-PCI, SUVmax, and SUVmax/SUVmean_liver were consistent with the PMP histopathological grade, while there was only a significant different between the PET-PCI of the high-and low-grade PMP. Conclusion Compared with SUVmax and SUVmax/SUVmean_liver, PET-PCI can better reflect the histopathological grade of PMP.

Key words: ¹⁸F-fluorodeoxyglucose, positrone emission tomography, pseudomyxoma peritonei, histopathological grade

中图分类号:

张丽, 李兵, 童冠圣. 基于¹⁸F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测[J]. 首都医科大学学报, 2022, 43(6): 834-839.

Zhang Li, Li Bing, Tong Guansheng. Prediction of tumor histopathological grade using a modified peritoneal cancer index by ¹⁸F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei[J]. Journal of Capital Medical University, 2022, 43(6): 834-839.

参考文献

[1] Sugarbaker P H. Pseudomyxoma peritonei. A cancer whose biology is characterized by a redistribution phenomenon[J]. Ann Surg, 1994, 219(2): 109－111.
[2] Carr N J, Finch J, Ilesley I C, et al. Pathology and prognosis in pseudomyxoma peritonei: a review of 274 cases[J]. J Clin Pathol, 2012, 65(10): 919－923.
[3] Carr N J, Cecil T D, Mohamed F, et al. A consensus for classification and pathologic reporting of pseudomyxoma peritonei and associated appendiceal neoplasia: the results of the peritoneal surface oncology group international (PSOGI) modified delphi process[J]. Am J Surg Pathol, 2016, 40(1): 14－26.
[4] Valasek M A, Pai R K. An update on the diagnosis, grading, and staging of appendiceal mucinous neoplasms[J]. Adv Anat Pathol, 2018, 25(1): 38－60.
[5] Li Y, Yu Y, Liu Y. Report on the 9(th) international congress on peritoneal surface malignancies[J]. Cancer Biol Med, 2014, 11(4): 281－284.
[6] Lin Y L, Xu D Z, Li X B, et al. Consensuses and controversies on pseudomyxoma peritonei: a review of the published consensus statements and guidelines[J]. Orphanet J Rare Dis, 2021, 16(1): 85.
[7] Portilla A G, Shigeki K, Dario B, et al. The intraoperative staging systems in the management of peritoneal surface malignancy[J]. J Surg Oncol, 2008, 98(4): 228－231.
[8] Sugarbaker P H, Chang D. Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy[J]. Ann Surg Oncol, 1999, 6(8): 727－731.
[9] Munoz-Zuluaga C A, King M C, Ledakis P, et al. Systemic chemotherapy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with high-grade mucinous carcinoma peritonei of appendiceal origin[J]. Eur J Surg Oncol, 2019, 45(9): 1598－1606.
[10] Blackham A U, Swett K, Eng C, et al. Perioperative systemic chemotherapy for appendiceal mucinous carcinoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy[J]. J Surg Oncol, 2014, 109(7): 740－745.
[11] Chua T C, Moran B J, Sugarbaker P H, et al. Early-and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy[J]. J Clin Oncol, 2012, 30(20): 2449－2456.
[12] Flicek K, Ashfaq A, Johnson C D, et al. Correlation of radiologic with surgical peritoneal cancer index scores in patients with pseudomyxoma peritonei and peritoneal carcinomatosis: how well can we predict resectability?[J]. J Gastrointest Surg, 2016, 20(2): 307－312.
[13] Yan F C, Lin Y L, Zhou Q, et al. Pathological prognostic factors of pseudomyxoma peritonei: comprehensive clinicopathological analysis of 155 cases[J]. Hum Pathol, 2020, 97: 9－18.
[14] Hotta M, Minamimoto R, Gohda Y, et al. Impact of a modified peritoneal cancer index using FDG-PET/CT (PET-PCI) in predicting tumor grade and progression-free survival in patients with pseudomyxoma peritonei[J]. Eur Radiol, 2019, 29(10): 5709－5716.
[15] Sirintrapun S J, Blackham A U, Russell G, et al. Significance of signet ring cells in high-grade mucinous adenocarcinoma of the peritoneum from appendiceal origin[J]. Hum Pathol, 2014, 45(8): 1597－1604.

基于¹⁸F-FDG代谢显像的腹膜假黏液瘤PCI评分及肿瘤分级预测

Prediction of tumor histopathological grade using a modified peritoneal cancer index by ¹⁸F-FDG PET/CT(PET-PCI)in patients with pseudomyxoma peritonei

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 5

编辑推荐

Metrics

本文评价

[1]	张姝, 王凯, 杨子皓, 乔真, 李晓桐, 袁磊磊, 艾林. ¹¹C-MET PET/CT筛查幕上较低级别胶质瘤IDH和1p/19q分子分型的应用价值[J]. 首都医科大学学报, 2022, 43(6): 826-833.
[2]	杨森, 王玲, 刘鹏, 金超岭, 李红磊, 富丽萍. ¹⁸F-FDG PET/CT显像中连续采集和步进采集的比较[J]. 首都医科大学学报, 2022, 43(6): 854-860.
[3]	罗诗雨, 李眉, 罗莎, 王爽, 张娟, 李萌, 南潇, 鲜军舫. ¹⁸F-FDG PET/CT在脉络膜黑色素瘤与脉络膜转移癌鉴别诊断中的应用价值[J]. 首都医科大学学报, 2022, 43(6): 867-872.
[4]	徐洋, 王凯, 陈嫱, 艾林. 核医学分子影像在胶质瘤诊疗中的研究进展[J]. 首都医科大学学报, 2022, 43(6): 880-885.
[5]	王丽, 武姣彦, 杨敏福. 初诊肺腺癌患者PET/CT显像的心肌代谢特征及影响左心室心肌代谢增高的因素分析[J]. 首都医科大学学报, 2021, 42(1): 1-7.