摘要目的 探究原发性胆管癌TNM分期与其18F-脱氧葡萄糖(FDG)正电子发射计算机断层扫描(PET/CT)半定量指标最大标准摄取值(SUVmax)的相关性.方法 回顾性分析温州医科大学附属第五医院2014年10月至2016年7月经临床确诊的36例原发性胆管癌患者的临床资料,所有患者均行18F-PET/CT检查,测定肿瘤病灶区域的SUVmax值,并据美国癌症联合委员会指南对肝内外原发性胆管癌进行临床分期,比较不同年龄、性别及分期胆管肿瘤患者之间SUVmax的差异,确定TNM分期与SUVmax之间的相关性.组间数据比较采用独立样本t检验.结果 36例原发性胆管癌SUVmax值为7.87 ±3.17(2.10～14.60),有淋巴结转移和有远处转移患者病灶区域的SUVmax值分别明显高于无淋巴结转移和无远处转移患者,差异均有统计学意义(t=0.364、0.343,均P＜0.05);不同TNM分期患者之间SUVmax差异同样具有统计学意义(F=1.352,P=0.021);但不同性别、年龄(＞ 70岁与＜70岁)和T分期患者肿瘤之间SUVmax差异无统计学意义(t=1.058、1.980,F=1.252,均P＞0.05).Spearman相关性分析发现,原发性胆管癌的TNM分期与其SUVmax呈显著的正相关,即肿瘤TNM分期越高,其SUVmax值也越高(r=0.658,P=0.007).结论 SUVmax值大小与原发性胆管癌的TNM分期呈正相关,对于胆管癌患者的临床分期及预后评估有一定的指导意义.

abstractsObjective To investigate the correlation between TNM staging of primary cholangiocarcinoma and the maximum standard uptake value (SUVmax) of 18 F-2-deoxy-D-glucose positron emission tomography with computerized tomography (18 F-FDG PET/CT).Methods A retrospective analysis of 36 patients with confirmed primary cholangiocarcinoma from October 2014 to July 2016 was carried out.All the patients underwent preoperative PET/CT in the Fifth Affiliated Hospital of Wenzhou Medical University from November 2014 to July 2016,the SUVmax was calculated by drawing region of interest around the primitive tumor area.According to the American Cancer Joint Committee (AJCC) guidelines for the clinical staging of intrahepatic and extrahepatic cholangiocarcinoma,the differences of SUVmax were compared in the patients with different age,gender and staging,and the correlation between TNM staging and SUVmax was determined.Data were compared with independent sample t test between groups.Results The mean SUVmax of 36 patients with primary cholangiocarcinoma was 7.87 ± 3.17 (2.1-14.6).The SUVmax values of patients with lymph node metastasis or distant metastasis were significantly higher than those without lymph node metastasis or distant metastasis (t =0.364,0.343,both P ＜ 0.05),respectively.There was significant difference in SUVmax between patients with different TNM staging (F =1.352,P =0.021).There was no significant differences in SUVmax between patient with different gender,age (＞ 70 years or ＜ 70 years) and T staging (t =1.058,1.980,F =1.252,all P ＞ 0.05).Spearman correlation analyses showed that the TNB stage of primary cholangiocarcinoma was positively correlated with its SUVmax (r =0.658,P =0.007).Conclusion The SUVmax is positively correlated with the TNM staging of primary cholangiocarcinoma,which is helpful for the clinical staging and prognosis of the patients.