原发性肺涎腺型肿瘤的18 F⁃脱氧葡萄糖正电子发射计算机断层扫描显像特点及临床特征

摘要

Objective To explore the imaging manifestation and clinical characteristics of primary salivary gland?type lung cancer using 18F?fluorodeoxy glucose ( 18 F?FDG) positron emission tomography／computed tomography ( PET?CT ). Methods From March 2009 to January 2017, 12 patients with pathologically confirmed primary salivary gland?type lung cancer were enrolled in First Affiliated Hospital of Nanjing Medical University. Their images and clinicopathological data were retrospectively analyzed. Results Six out of 12 patients had mucoepidermoid carcinoma (MEC), and the other six patients had adenoid cystic carcinoma (ACC). Five MEC were located in the main bronchus, and the other one was in segmental bronchus. Intrabronchial nodule or mass with smooth or lobulated margin and calcification(n＝3) was the main 18F?FDG PET?CT features of MEC. Two ACC involved trachea, two involved the main bronchi, and the other two involved lobular bronchi. The main 18F?FDG PET?CT features of ACC were diffuse or circumferential irregular thickness of the bronchial wall, distorted lumen, and the longitudinal extent of the tumor was greater than its transverse axis.The 18F?FDG uptake of all lesions was increased in varying degree. The median (25th percentile, 75th percentile) value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were 5.1(3.1,8.1), 5.7(1.2,21.4) cm3 and 18.6 ( 0.6, 93.7), respectively. All of them were related to pathological grading and nodal tumor involvement( all P＜0.05), but not associated with tumor location or pathological type( all P＞0.05). MTV and TLG were also related to clinical stage( all P＜0.05). Tumor size was correlated with MTV, TLG of primary lesions(r＝0.607,P＝0.036;r＝0.579,P＝0.049), but not with SUVmax(r＝0.568,P＝0.054). Conclusions Primary salivary gland?type lung cancer mainly occurs in segmental bronchus. The MTV and TLG of the tumor calculated by 18F?FDG PET?CT are correlated with clinicopathological characteristics, and are helpful for clinical diagnosis and treatment.%目的 探讨原发性肺涎腺型肿瘤18F?脱氧葡萄糖( 18 F?FDG)正电子发射计算机断层扫描(PET?CT)显像特点和临床特征.方法 收集2009年3月至2017年1月就诊于南京医科大学第一附属医院、经病理确诊的12例原发性肺涎腺型肿瘤患者的临床资料和18 F?FDG PET?CT显像资料.回顾性分析12例患者的18F?FDG PET?CT显像特点和临床病理特征.结果 12例原发性肺涎腺型肿瘤患者中,黏液表皮样癌( MEC) 6例,腺样囊性癌( ACC) 6例. 6例MEC患者中,位于段支气管内5例,位于主气管内1例;18F?FDG PET?CT表现为支气管内类圆形或浅分叶软组织密度结节、肿块,边缘光滑,3例可见点状钙化. 6例ACC患者中,病灶位于气管2例,主支气管2例,叶支气管各2例;18F?FDG PET?CT表现为气管或支气管壁弥漫或环形不规则增厚,管腔变形,病灶纵径大于横径. 12例患者的病灶18F?FDG 代谢不同程度增高,最大标准摄取值( SUVmax)、代谢体积( MTV)和病灶糖酵解总量(TLG)的中位数(第25百分数,第75百分数)分别为5.1(3.1,8.1)、5.7 cm3(1.2 cm3,21.4 cm3)和18.6(0.6,93.7).患者的SUVmax、MTV和TLG分别与病理分级和淋巴结转移均有关(均P＜0.05),而与病灶位置和病理类型均无关(均P＞0.05);患者的MTV和TLG与临床分期均有关(均P＜0.05).病灶大小与SUVmax无相关性(r＝0.568,P＝0.054),而与 MTV 和 TLG 均呈正相关( r＝0.607,P＝0.036;r＝0.579,P＝0.049).结论 原发性肺涎腺型肿瘤好发于段支气管及以上支气管,18 F?FDG PET?CT显像所测得的MTV和TLG与患者的临床病理特征有关,能为临床诊治提供依据.