Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, Korea.
Clin Endocrinol (Oxf). 2018 Jun;88(6):963-968. doi: 10.1111/cen.13604. Epub 2018 Apr 16.
We investigated the predictive role of functional visceral fat activity evaluated by preoperative F-18 FDG PET/CT for regional lymph node metastasis in patients with differentiated thyroid cancer.
Fifty-eight patients with newly diagnosed differentiated thyroid cancer were enrolled in this study, retrospectively (men 14; women 44; age 53 ± 14.5). They all received preoperative F-18 FDG PET/CT and surgery. Functional visceral fat activity was defined as maximum standardized uptake value (SUVmax) of visceral fat divided by SUVmax of subcutaneous fat (V/S ratio). Pathology results were confirmed through the surgical specimens.
The patients with regional lymph node metastasis showed higher functional visceral fat activity (V/S ratio) than the patients without regional lymph node metastasis (2.12 ± 0.6 vs 1.62 ± 0.34, P = .001). V/S ratio of 1.78 was suggested as an optimal cut-off value for predicting regional lymph node metastasis (sensitivity; 70.3%, specificity; 83.3%, area under the curve; 0.778, P < .0001). Furthermore, functional visceral fat activity was significantly associated with regional lymph node metastasis in patients with differentiated thyroid cancer by univariate and multivariate analyses.
Functional visceral fat activity significantly affects the regional lymph node metastasis status in patients with differentiated thyroid cancer. Furthermore, it may also be useful to predict regional lymph node metastasis.
本研究旨在探讨术前 F-18 FDG PET/CT 评估的功能性内脏脂肪活性对分化型甲状腺癌患者区域淋巴结转移的预测作用。
本研究回顾性纳入 58 例新诊断为分化型甲状腺癌的患者（男性 14 例，女性 44 例，年龄 53 ± 14.5 岁）。所有患者均接受了术前 F-18 FDG PET/CT 和手术。功能性内脏脂肪活性定义为内脏脂肪的最大标准化摄取值（SUVmax）除以皮下脂肪的 SUVmax（V/S 比值）。通过手术标本证实了病理学结果。
有区域淋巴结转移的患者的功能性内脏脂肪活性（V/S 比值）高于无区域淋巴结转移的患者（2.12 ± 0.6 比 1.62 ± 0.34，P =.001）。V/S 比值为 1.78 被建议作为预测区域淋巴结转移的最佳截断值（灵敏度为 70.3%，特异性为 83.3%，曲线下面积为 0.778，P <.0001）。此外，单因素和多因素分析均表明，功能性内脏脂肪活性与分化型甲状腺癌患者的区域淋巴结转移显著相关。
功能性内脏脂肪活性显著影响分化型甲状腺癌患者的区域淋巴结转移状态。此外，它可能有助于预测区域淋巴结转移。
