Sagawa Motoyasu, Higashi Kotaro, Sugita Makoto, Ueda Yoshimichi, Maeda Sumiko, Toga Hirohisa, Sakuma Tsutomu
Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan.
Surg Today. 2006;36(3):230-4. doi: 10.1007/s00595-005-3123-3.
Noguchi and colleagues reported that the growth pattern of small-sized adenocarcinoma was related to the vascular involvement and the prognosis of the patient. Noguchi's type A/B tumors had no lymph node metastasis, rare vascular involvement, and an excellent prognosis, which meant that Noguchi's type A/B tumors were preinvasive tumors of the peripheral type. Although Noguchi's classification was usually determined based on resected specimens, it would be useful to make a decision about the therapeutic strategy if the classification could be determined preoperatively based on the fluorodeoxyglucose (FDG) uptake.
The FDG uptake in 61 pulmonary adenocarcinomas measuring 3 cm or smaller in diameter was compared with the mediastinal uptake and was classified into five grades. The relationship between the FDG uptake and Noguchi's classification (A to F) was analyzed.
The FDG uptake was significantly lower in Noguchi's type A/B tumors than in type C or in type D/E/F. Eleven of 12 tumors (92%) with no increased or a weak FDG uptake were classified as type A/B, whereas 32 of 33 tumors (97%) with a strong or very strong FDG uptake were classified as type C-F.
The FDG uptake is helpful for making an accurate diagnosis of Noguchi's classification preoperatively in patients with pulmonary adenocarcinoma.
野口及其同事报告称，小尺寸腺癌的生长模式与血管受累情况及患者预后相关。野口A型/B型肿瘤无淋巴结转移，血管受累情况罕见，预后良好，这意味着野口A型/B型肿瘤为外周型的浸润前肿瘤。尽管野口分类通常基于切除标本确定，但如果能在术前根据氟脱氧葡萄糖（FDG）摄取情况确定分类，对于制定治疗策略将很有帮助。
对61例直径3 cm及以下的肺腺癌的FDG摄取情况与纵隔摄取情况进行比较，并分为五个等级。分析FDG摄取与野口分类（A至F）之间的关系。
野口A型/B型肿瘤的FDG摄取显著低于C型或D/E/F型。12例FDG摄取未增加或摄取较弱的肿瘤中有11例（92%）被分类为A型/B型，而33例FDG摄取较强或非常强的肿瘤中有32例（97%）被分类为C-F型。
FDG摄取有助于术前对肺腺癌患者的野口分类做出准确诊断。
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