Shibata Hidekatsu, Nomori Hiroaki, Uno Kimiichi, Iyama Ken-Ichi, Tomiyoshi Katsumi, Nakashima Rumi, Sakaguchi Kazuya, Goya Tomoyuki, Takanami Iwao, Koizumi Kiyoshi, Suzuki Takashi, Kaji Masahiro, Horio Hirotoshi
Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
Ann Nucl Med. 2009 Sep;23(7):609-16. doi: 10.1007/s12149-009-0278-9. Epub 2009 Jun 30.
To determine the usefulness of positron emission tomography (PET) with (11)C-acetate (AC) for imaging lung adenocarcinoma and evaluating its tumor aggressiveness, AC- and (18)F-fluorodeoxyglucose (FDG)-PET were compared.
One hundred and sixty-nine adenocarcinomas with clinical stage IA and 53 benign nodules were examined by both AC- and FDG-PET before surgery. The sensitivity and specificity for discriminating benign/adenocarcinoma were compared between AC- and FDG-PET. The AC and FDG uptakes were examined to determine the relationship with tumor aggressiveness, i.e., pathological tumor stage, lymphatic, vascular, or pleural involvement, and proliferative activity determined by Ki-67 staining score.
While the sensitivity of AC-PET was significantly higher than FDG-PET for bronchioloalveolar carcinoma (BAC) and well-differentiated (W/D) adenocarcinoma (p < 0.001 and 0.006, respectively), there was no significant difference for moderately or poorly differentiated adenocarcinoma. The specificity was not different between them. While FDG uptakes were significantly higher in tumors with pathological advanced stages or those with lymphatic, vascular and/or pleural involvements than in tumors with pathological stage IA or those without these tumor involvements (p = 0.04 to p < 0.001), AC uptake did not show significant differences between the respective sub-groups except according to the tumor stage. While both AC and FDG uptakes showed a significant correlation with Ki-67 staining scores (p = 0.03 and p < 0.001, respectively), the correlation coefficient of former was lower than that of latter (p = 0.07).
While AC-PET can image BAC and W/D adenocarcinoma with a higher sensitivity than FDG-PET, it cannot evaluate tumor aggressiveness of clinical stage IA lung adenocarcinoma as well as FDG-PET.
为了确定使用¹¹C - 醋酸盐（AC）的正电子发射断层扫描（PET）对肺腺癌成像及评估其肿瘤侵袭性的效用，对AC - PET和¹⁸F - 氟脱氧葡萄糖（FDG） - PET进行了比较。
169例临床IA期腺癌和53个良性结节在手术前均接受了AC - PET和FDG - PET检查。比较AC - PET和FDG - PET鉴别良性/腺癌的敏感性和特异性。检测AC和FDG摄取情况以确定其与肿瘤侵袭性的关系，即病理肿瘤分期、淋巴、血管或胸膜受累情况，以及通过Ki - 67染色评分确定的增殖活性。
对于细支气管肺泡癌（BAC）和高分化（W/D）腺癌，AC - PET的敏感性显著高于FDG - PET（分别为p < 0.001和0.006），而对于中分化或低分化腺癌则无显著差异。两者的特异性无差异。FDG摄取在病理晚期肿瘤或伴有淋巴、血管和/或胸膜受累的肿瘤中显著高于病理IA期肿瘤或无这些肿瘤受累的肿瘤（p = 0.04至p < 0.001），而AC摄取除了根据肿瘤分期外，在各亚组之间未显示出显著差异。虽然AC和FDG摄取均与Ki - 67染色评分显著相关（分别为p = 0.03和p < 0.001），但前者的相关系数低于后者（p = 0.07）。
虽然AC - PET对BAC和W/D腺癌成像的敏感性高于FDG - PET，但它对临床IA期肺腺癌肿瘤侵袭性的评估不如FDG - PET。
Zotero 插件