Objective To investigate the relationship between 18F-fluoromisonidazole (18F-FMISO) PET hypoxia image and the clinical pathological parameters of nasopharyngeal carcinoma (NPC).Methods From Oct.2011 to Nov.2012, 39 patients who were diagnosed as NPC were enrolled: 12 patients were without radiotherapy or chemotherapy, and 27 patients were treated with chemotherapy using docetaxel and nedaplatin.According to the 7th edition UICC staging standard T stage nasopharyngeal carcinoma (2009 version), of the 39 cases, the numbers of patients within T staging 1, 2, 3 and 4 were 3, 14, 13 and 9, respectively.18F-FMISO PET/CT were performed at PET/CT center of Wuxi No.4 Hosptial, with comparison of primary tumor radioactivity uptake visual analysis and SUVmax quantitative value in the non-treatment group and treatment group, different T staging respectively.In addition, correlation between primary tumor size and SUVmax quantitative value were also analyzed.Mann-Whitney test was preformed to evaluate the difference between the non-treatment group and treatment group of primary tumor radioactivity uptake visual analysis and SUVmax quantitative value.With spearman correlation analysis, visual analysis were used to evaluate different T staging of primary tumor radioactivity uptake, and Kruskal-Wallis test was used for the correlation of different T staging group and SUVmax;t-test was used for the correlation study of quantitative analysis between primary tumor size and the SUVmax.Results There was no statistical significance between the groups of non-treatment and treatment for primary tumor radioactivity uptake visual analysis (U=107.5, P=0.098), or for SUVmax quantitative value (U=118,P=0.188).Under visual analysis of primary tumor radioactivity uptake, correlation between different T staging and radioactivity uptake was moderate (rs=0.513,P=0.001), and the difference among different T staging SUVmax value was statistically significant (H=9.733,P=0.021).It was correlated between primary tumor size and the SUVmax.The gross tumor volume of NPC was divided into two groups based on the median size 26.6mm3: SUVmax in small and large group is 1.41±0.21, and 2.05±0.86 respectively, which differences was statistically significant (t=-3.11,P=0.004).Conclusion SUVmax of 18F-FMISO PET hypoxia image in nasopharyngeal carcinoma was correlated with primary tumor size and the T stage, but had no obvious relationship with treatment.The extent of hypoxia correlated with tumor volume indicates that 18F-FMISO PET/CT would be valuable in predicting response to therapy and prognosis of patients for NPC, and might have potential clinical value in guiding outline of biological targets in NPC.%目的 探讨18氟-米索硝唑(18F-FMISO)乏氧显像与鼻咽癌临床相关参数的相关性.方法 研究对象为2013年10月至2014年11月间经病理学确诊为鼻咽癌的患者39例,依治疗情况分为未化疗组和化疗组,未化疗组12例,化疗组(多西他赛联合奈达铂静脉化疗)27例;按照2009年鼻咽癌第7版UICC分期标准进行T分期, T1期3例,T2期14例,T3期13例,T4期9例.39例患者均进行18F-FMISO PET/CT显像;采用Mann-Whitney U检验比较鼻咽癌未化疗组和化疗组的原发灶放射性摄取视觉分析有无差异,以及两组间的SUVmax值有无差异;采用秩相关检验(Spearman相关)进行不同T分期肿瘤原发灶放射性摄取视觉分析,Kruskal-Wallis检验比较不同T分期肿瘤原发灶SUVmax值有无差异;以鼻咽癌大体肿瘤体积中位数26.6mm3为分界点,将原发灶分为两组,采用成组t检验比较两组间SUVmax的差异.结果 ①未化疗组和化疗组的原发灶视觉分析显示两组间差异无统计学意义(U=107.5,P=0.098),两组间SUVmax值差异无统计学意义(U=118,P=0.188).②不同T分期肿瘤原发灶放射性摄取视觉分析显示T分期与放射性摄取存在中等程度相关性( rs=0.513,P=0.001),不同T分期的SUVmax值差异有统计学意义(H=9.733,P=0.021).③体积≤26.6mm3组的SUVmax为1.41±0.21,体积>26.6 mm3组的SUVmax为2.05±0.86,两组间差异有统计学意义(t=-3.11,P=0.004).结论 鼻咽癌18F-FMISO乏氧显像原发灶SUVmax值与原发肿瘤大小及T分期之间存在相关性,与鼻咽癌化疗与否无明显统计学差异,提示肿瘤越大乏氧程度越明显,并对指导鼻咽癌生物靶区勾画具有一定的临床价值.
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