[1]柳卫,李天女,范磊,等.肺大细胞神经内分泌癌的18F-FDG PET/CT表现[J].国际放射医学核医学杂志,2018,(6):486-490.[doi:10.3760/cma.j.issn.1673-4114.2018.06.002]
 Liu Wei,Li Tiannyu,Fan Lei,et al.18F-FDG PET/CT manifestations of pulmonary large cell neuroendocrine carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(6):486-490.[doi:10.3760/cma.j.issn.1673-4114.2018.06.002]
点击复制

肺大细胞神经内分泌癌的18F-FDG PET/CT表现(/HTML)
分享到:

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第6期
页码:
486-490
栏目:
临床研究
出版日期:
2018-12-31

文章信息/Info

Title:
18F-FDG PET/CT manifestations of pulmonary large cell neuroendocrine carcinoma
作者:
柳卫 李天女 范磊 丁重阳
1. 210029, 南京医科大学第一附属医院核医学科;
2. 210029, 南京医科大学第一附属医院血液科
Author(s):
Liu Wei Li Tiannyu Fan Lei Ding Chongyang
1. Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;
2. Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
关键词:
肺肿瘤神经内分泌癌正电子发射断层显像计算机体层摄影术氟脱氧葡萄糖F18
Keywords:
Lung neoplasmsNeuroendocrine carcinomaPositron emission tomography computed tomographyFluorodeoxyglucose F18
DOI:
10.3760/cma.j.issn.1673-4114.2018.06.002
摘要:
目的 探讨肺大细胞神经内分泌癌(LCNEC)的18F-氟脱氧葡萄糖(FDG)PET/CT的影像学表现。方法 回顾性分析2009年10月至2017年5月经病理证实的37例肺LCNEC患者的18F-FDG PET/CT影像学表现,包括病灶位置、形态特征、代谢和淋巴结转移情况,以及最大标准化摄取值(SUVmax)预测淋巴结转移的价值。SUVmax与肿瘤最大径的相关性采用Pearson相关性分析。结果 37例肺LCNEC患者均为单发,其中周围型28例(28/37,75.7%)、中央型9例(9/37,24.3%)。30例病灶(30/37,81.1%)可见分叶征,多为浅分叶;10例病灶(10/37,27.0%)可见毛刺征。29例病灶(29/37,78.4%)边界清晰,9例病灶(9/37,24.3%)可见胸膜凹陷征,2例病灶可见液化坏死,1例病灶可见空洞形成,1例病灶内见点状钙化,1例病灶内见充气支气管征。37例病灶18F-FDG 代谢程度均高于肝脏,SUVmax为11.7±5.2(3.3~25.3),肿瘤最大径为(3.2±1.5)cm,SUVmax与肿瘤最大径呈正相关(r=0.569,P=0.000)。15例病灶伴有肺门和(或)纵隔淋巴结转移,8例可见远处转移,包括骨转移4例、肾上腺转移1例、肝脏及骨转移2例、肾上腺及骨转移1例。约登指数最大为0.573,所对应的SUVmax为11.9,诊断效率最高,灵敏度为80.0%,特异度为77.3%。结论 肺LCNEC的18F-FDG PET/CT多表现为周围型类圆形软组织结节或肿块,边缘清晰,充气支气管征少见,18F-FDG 摄取较高。原发肿瘤SUVmax是判断淋巴结转移的重要半定量指标。
Abstract:
Objective To investigate the 18F-FDG PET/CT manifestations of pulmonary large cell neuroendocrine carcinoma(LCNEC). Methods The 18F-FDG PET/CT manifestations of 37 lung LCNEC patients confirmed by pathology from October 2009 to May 2017 were analyzed. These manifestations include lesion location, shape characteristics, lymph node metastasis, lesion metabolism, and predictive value of primary tumor maximum standardized uptake value(SUVmax) for lymph node metastasis. Pearson’s correlation was used to analyze the relation between primary tumor SUVmax and maximum tumor diameter. Results All 37 patients with lung LCNEC were with single lung node, including 28 patients located peripherally(28/37, 75.7%) and 9 patients located centrally(9/37, 24.3%). Lobulation of tumors was found in 30 cases(30/37, 81.1%), and spiculation was observed in 10 cases(10/37, 27.0%). The tumors were smooth and well defined in 29 cases(29/37, 78.4%), whereas pleural indentation, necrosis, cavity, calcification, and air bronchograms were found in 9, 2, 1, 1, and 1 cases, respectively. The metabolism of 18F-FDG in 37 lesions was higher than that in the liver. The SUVmax was 11.7±5.2(3.3-25.3), and the maximum tumor diameter(3.2±1.5) cm. These two parameters showed a positive correlation(r=0.569, P=0.000). Mediastinal and/or hilar lymphadenectasis was observed in 15 cases. Distant metastasis was observed in 8 cases, including bone metastasis in 4 cases, adrenal gland metastasis in 1 cases, liver and bone metastasis in 2 cases, and adrenal gland and bone metastasis in 1 case. Primary tumor SUVmax had a predictive value for lymph node metastasis. When the cut-off value was 11.9, the Youden index was 0.573, and the diagnostic efficiency was the highest with 80% sensitivity and 77.3% specificity. Conclusions The 18F-FDG PET/CT manifestations of most pulmonary large cell neuroendocrine carcinoma are characterized by round soft tissue nodules or masses with clear margins, rare air bronchograms, and high 18F-FDG uptake. Primary tumor SUVmax is an important semi-quantitative indicator for predicting lymph mode metastasis.

参考文献/References:

[1] Kasajima A, Ishikaw a Y, Iwata A, et al. Inflammation and PD-L1 expression in pulmonary neuroendocrine tumors[J]. Endocr Relat Cancer, 2018, 25(3):339-350. DOI:10.1530/ERC-17-0427.
[2] Derks JL, Leblay N, Thunnissen E, et al. Molecular Subtypes of Pulmonary Large-cell Neuroendocrine Carcinoma Predict Chemotherapy Treatment Outcome[J]. Clin Cancer Res, 2018, 24(1):33-42. DOI:10.1158/1078-0432.CCR-17-1921.
[3] Cattoni M, Vallières E, Brown LM, et al. Improvement in TNM staging of pulmonary neuroendocrine tumors requires histology and regrouping of tumor size[J]. J Thorac Cardiovasc Surg, 2018, 155(1):405-413. DOI:10.1016/j.jtcvs.2017.08.102.
[4] Hoton D, Humblet Y, Libbrecht L. Phenotypic variation of an ALK-positive large-cell neuroendocrine lung carcinoma with carcinoid morphology during treatment with ALK inhibitors[J]. Histopathology, 2018, 72(4):707-710. DOI:10.1111/his.13388.
[5] Akata S, Okada S, Maeda J, et al. Computed tomographic findings of large cell neuroendocrine carcinoma of the lung[J]. Clin Imaging, 2007, 31(6):379-84. DOI:10.1016/j.clinimag.2007.04.027.
[6] 郭健, 叶兆祥, 冯小伟, 等. 肺大细胞神经内分泌癌的MSCT表现[J]. 中国医学影像技术, 2013, 29(1):79-83. Guo J, Ye ZX, Feng XW, et al. MSCT findings of lung large cell neuroendocrine carcinoma[J]. Chin J Med Imaging Technol, 2013, 29(1):79-83.
[7] 金民山,张俊,姜一逸, 等. 18F-FDG PET/CT在不明原发灶肿瘤中的临床应用价值[J]. 国际放射医学核医学杂志, 2017, 41(2):94-97. DOI:10.3760/cma.j.issn.1673-4114.2017.02.003. Jin MS, Zhang J, Jiang YY, et al. Clinical value of 18F-FDG PET/CT in cancer of unknown primary[J]. Int J Radiat Med Nucl Med, 2017, 41(2):94-97. DOI:10.3760/cma.j.issn.1673-4114. 2017.02. 003.
[8] Lee KW, Lee Y, Oh SW, et al. Large cell neuroendocrine carcinoma of the lung:CT and FDG PET findings[J]. Eur J Radiol, 2015, 84(11):2332-2338. DOI:10.1016/j.ejrad.2015.07.033.
[9] Kaira K, Murakami H, Endo M, et al. Biological correlation of 18F-FDG uptake on PET in pulmonary neuroendocrine tumors[J]. Anticancer Res, 2013, 33(10):4219-4228.
[10] 严振辉, 柳学国, 何亚奇, 等. 肺大细胞神经内分泌癌的临床影像学特点与诊断(附22例分析)[J]. 现代医用影像学, 2015, 24(3):375-379. Yan ZH, Liu XG, He YQ, et al. Clinical imaging and characteristics diagnosis of pulmonary large cell neuroendocrine carcinoma (Analysis of 22 cases)[J]. Mod Med Imagel, 2015, 24(3):375-379.
[11] 钱哲, 胡瑛, 郑华, 等. 肺大细胞神经内分泌癌22例临床分析[J]. 中国肺癌杂志,2016, 19(2):82-87. DOI:10.3779/j.issn.1009-3419.2016.02.05. Qian Z, Hu Y, Zheng H, et al. Clinical analysis of 22 cases of pulmonary large cell neuroendocrine cancer[J]. Chin J Lung Cancer, 2016, 19(2):82-87. DOI:10.3779/j.issn.1009-3419. 2016. 02.05.
[12] Kaseda K, Asakura K, Kazama A, et al. Risk Factors for Predicting Occult Lymph Node Metastasis in Patients with Clinical Stage I Non-small Cell Lung Cancer Staged by Integrated Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography[J]. World J Surg, 2016, 40(12):2976-2983. DOI:10.1007/s00268-016-3652-5.

相似文献/References:

[1]麦卫平,张永林.能谱CT成像在肺癌诊断中的应用研究进展[J].国际放射医学核医学杂志,2016,40(1):77.[doi:10.3760/cma.j.issn.1673-4114.2016.01.015]
 Mai Weiping,Zhang Yonglin.Research progress of spectral imaging in the diagnosis of lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):77.[doi:10.3760/cma.j.issn.1673-4114.2016.01.015]
[2]霍小东,王慧星,阎卫亮,等.血管内皮抑制素对125I近距离照射裸鼠肺癌移植瘤的增敏效应研究[J].国际放射医学核医学杂志,2016,40(5):357.[doi:10.3760/cma.j.issn.1673-4114.2016.05.006]
 Huo Xiaodong,Wang Huixing,Yan Weiliang,et al.Sensitization effect of endostatin for 125I brachytherapy on transplanted tumor in nude mice[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):357.[doi:10.3760/cma.j.issn.1673-4114.2016.05.006]
[3]张艳兰,孙琦婷,武萍,等.呼吸门控PET/CT对于肺癌放疗靶区勾画的指导[J].国际放射医学核医学杂志,2015,39(2):105.[doi:10.3760/cma.j.issn.1673-4114.2015.02.001]
 Zhang Yanlan,Sun Qiting,Wu Ping,et al.Guiding the target delineation in radiation therapy of lung cancer by respiratory gated PET/CT[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):105.[doi:10.3760/cma.j.issn.1673-4114.2015.02.001]
[4]张高潮,马丽,寇莹,等.99Tcm-tetrofosmin SPECT诊断肺部肿瘤的临床价值[J].国际放射医学核医学杂志,2015,39(4):303.[doi:10.3760/cma.j.issn.1673-4114.2015.04.007]
 Zhang Gaochao,Ma Li,Kou Ying,et al.Clinical value of 99Tcm-tetrofosmin SPECT in the diagnosis of lung neoplasms[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):303.[doi:10.3760/cma.j.issn.1673-4114.2015.04.007]
[5]付畅,史大鹏,徐俊玲,等.不同组织学类型肺癌患者大脑静息葡萄糖代谢改变研究[J].国际放射医学核医学杂志,2014,38(2):75.[doi:10.3760/cma.j.issn.1673-4114.2014.02.002]
 Fu Chang,Shi Dapeng,Xu Junling,et al.The preliminary study of brain glucose metabolism changes in patients with lung cancer of different histological types[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):75.[doi:10.3760/cma.j.issn.1673-4114.2014.02.002]
[6]张俊涛.晚期肺癌125I粒子植入治疗近期疗效观察[J].国际放射医学核医学杂志,2014,38(2):94.[doi:10.3760/cma.j.issn.1673-4114.2014.02.006]
 Zhang Juntao.Short-term efficacy of 125I seeds implantation in the treatment of advanced lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):94.[doi:10.3760/cma.j.issn.1673-4114.2014.02.006]
[7]杨心蕊,卫华,郝新忠,等.过敏性肺炎伴左肺动脉栓塞18F-FDGPET/CT误诊肺癌一例[J].国际放射医学核医学杂志,2014,38(2):135.[doi:10.3760/cma.j.issn.1673-4114.2014.02.014]
[8]王芹,杜利清,徐畅,等.白细胞介素21基因联合放射对肺癌细胞生长的协同抑制作用[J].国际放射医学核医学杂志,2014,38(3):161.[doi:10.3760/cma.j.issn.1673-4114.2014.02.005]
 Wang Qin,Du Liqing,Xu Chang,et al.Synergism inhibition effect of adenovirus-mediated IL-21 gene combined with ionizing radiation on the growth of pulmonary carcinoma cells[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):161.[doi:10.3760/cma.j.issn.1673-4114.2014.02.005]
[9]朱同华,杨鸿林,钮丽萍.血浆CYFRA21-1和CA125、CA199、CA153联合检测对肺癌的辅助诊断价值[J].国际放射医学核医学杂志,2014,38(5):304.[doi:10.3760/cma.j.issn.1673-4114.2014.05.007]
 Zhu Tong-hua,Yang Hong-lin,Niu Li-ping.The value of combined detection of plasma CYFRA21-1 and CA125, CA199, CA153 in the accessory diagnosis of lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(6):304.[doi:10.3760/cma.j.issn.1673-4114.2014.05.007]
[10]廖江荣,蒲德利,程毅力,等.经纤支镜和经皮联合植入125I粒子治疗晚期肺癌气管狭窄的临床分析[J].国际放射医学核医学杂志,2013,37(3):165.[doi:10.3760/cma.j.issn.1673-4114.2013.03.009]
 LIAO Jiang-rong,PU De-li,CHENG Yi-li,et al.The clinical analysis of 125I particles implantation by fibrobronchoscope and percutaneous in the treatment of tracheal stenosis of advanced lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2013,37(6):165.[doi:10.3760/cma.j.issn.1673-4114.2013.03.009]

备注/Memo

备注/Memo:
收稿日期:2018-04-21。
基金项目:江苏省优秀青年基金(BK20160099);江苏省六大高峰人才基金(2015-WSN-050)
通讯作者:丁重阳,Email:chongyangding@163.com
更新日期/Last Update: 2018-12-31