Kim Byung Seup, Ryu Han Suk, Kang Kyung Ho
Department of Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea.
J Int Med Res. 2013 Apr;41(2):445-56. doi: 10.1177/0300060513475743. Epub 2013 Feb 5.
To evaluate the clinical usefulness of preoperative positron emission tomography-computed tomography (PET-CT) in primary papillary thyroid cancer (PTC).
Preoperative PET-CT scans of patients with biopsy-confirmed PTC who were undergoing thyroidectomy were examined and the maximum standardized uptake value (SUV max) of 2-deoxy-2-((18)F)fluoro-D-glucose ((18)F-FDG) was calculated. Demographic and clinical data were obtained from medical records. Tumour tissue was pathologically classified according to World Health Organization guidelines. Univariate and multivariate analyses were performed to determined the demographic, clinical and pathological factors affecting PET positivity and SUV max.
The study included 194 patients. Multivariate analysis indicated that patients were significantly more likely to be PET positive if they were female, had larger tumours (>1 cm), coexisting pathology (nodular hyperplasia or Hashimoto's thyroiditis) or nonfollicular variant PTC. SUV max <2.0 indicated possible follicular variant PTC.
PET-positive results were unrelated to extrathyroidal extension and lymph node metastasis. PET positivity was related to larger tumour size and implied coexisting pathology. PET negativity or low SUV max suggested possible follicular variant PTC.
评估术前正电子发射断层扫描-计算机断层扫描（PET-CT）在原发性甲状腺乳头状癌（PTC）中的临床应用价值。
对经活检确诊为PTC且正在接受甲状腺切除术的患者进行术前PET-CT扫描，计算2-脱氧-2-（（18）F）氟-D-葡萄糖（（18）F-FDG）的最大标准化摄取值（SUV max）。从病历中获取人口统计学和临床数据。根据世界卫生组织指南对肿瘤组织进行病理分类。进行单因素和多因素分析以确定影响PET阳性和SUV max的人口统计学、临床和病理因素。
该研究纳入了194例患者。多因素分析表明，如果患者为女性、肿瘤较大（>1 cm）、存在共存病变（结节性增生或桥本甲状腺炎）或非滤泡型PTC，则其PET阳性的可能性显著更高。SUV max<2.0提示可能为滤泡型PTC。
PET阳性结果与甲状腺外侵犯和淋巴结转移无关。PET阳性与肿瘤较大有关，并提示存在共存病变。PET阴性或低SUV max提示可能为滤泡型PTC。
