Ding C Y, Li Y Y, Sun J, Guo Z, Li T R
Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Zhong Liu Za Zhi. 2019 Apr 23;41(4):288-293. doi: 10.3760/cma.j.issn.0253-3766.2019.04.008.
To explore the imaging manifestation and clinical characteristics of primary salivary gland-type lung cancer using (18)F-fluorodeoxy glucose ((18)F-FDG) positron emission tomography/computed tomography (PET-CT). From March 2009 to January 2017, 12 patients with pathologically confirmed primary salivary gland-type lung cancer were enrolled in First Affiliated Hospital of Nanjing Medical University. Their images and clinicopathological data were retrospectively analyzed. Six out of 12 patients had mucoepidermoid carcinoma (MEC), and the other six patients had adenoid cystic carcinoma (ACC). Five MEC were located in the main bronchus, and the other one was in segmental bronchus. Intrabronchial nodule or mass with smooth or lobulated margin and calcification(=3) was the main (18)F-FDG PET-CT features of MEC. Two ACC involved trachea, two involved the main bronchi, and the other two involved lobular bronchi. The main (18)F-FDG PET-CT features of ACC were diffuse or circumferential irregular thickness of the bronchial wall, distorted lumen, and the longitudinal extent of the tumor was greater than its transverse axis. The (18)F-FDG uptake of all lesions was increased in varying degree. The median (25th percentile, 75th percentile) value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were 5.1(3.1, 8.1), 5.7(1.2, 21.4)cm(3) and 18.6(0.6, 93.7), respectively. All of them were related to pathological grading and nodal tumor involvement( all <0.05), but not associated with tumor location or pathological type( all >0.05). MTV and TLG were also related to clinical stage( all <0.05). Tumor size was correlated with MTV, TLG of primary lesions(=0.607, =0.036; =0.579, =0.049), but not with SUVmax(=0.568, =0.054). Primary salivary gland-type lung cancer mainly occurs in segmental bronchus. The MTV and TLG of the tumor calculated by (18)F-FDG PET-CT are correlated with clinicopathological characteristics, and are helpful for clinical diagnosis and treatment.
采用(18)F-氟脱氧葡萄糖((18)F-FDG)正电子发射断层显像/计算机断层扫描(PET-CT)探讨原发性涎腺型肺癌的影像表现及临床特征。2009年3月至2017年1月,南京医科大学第一附属医院收治12例经病理确诊的原发性涎腺型肺癌患者。对其影像及临床病理资料进行回顾性分析。12例患者中,6例为黏液表皮样癌(MEC),另6例为腺样囊性癌(ACC)。5例MEC位于主支气管,1例位于段支气管。支气管内结节或肿块,边缘光滑或分叶状,伴钙化(≥3处)是MEC主要的(18)F-FDG PET-CT表现。2例ACC累及气管,2例累及主支气管,另2例累及小叶支气管。ACC主要的(18)F-FDG PET-CT表现为支气管壁弥漫性或环形不规则增厚、管腔变形,肿瘤纵向范围大于横向范围。所有病灶的(18)F-FDG摄取均有不同程度增加。最大标准摄取值(SUVmax)、代谢肿瘤体积(MTV)和总病灶糖酵解(TLG)的中位数(第25百分位数,第75百分位数)分别为5.1(3.1,8.1)、5.7(1.2,21.4)cm³和18.6(0.6,93.7)。三者均与病理分级及淋巴结肿瘤累及有关(均<0.05),但与肿瘤位置或病理类型无关(均>0.05)。MTV和TLG也与临床分期有关(均<0.05)。肿瘤大小与原发灶的MTV、TLG相关(r=0.607,P=0.036;r=0.579,P=0.049),但与SUVmax无关(r=0.568,P=0.054)。原发性涎腺型肺癌主要发生于段支气管。(18)F-FDG PET-CT计算的肿瘤MTV和TLG与临床病理特征相关,有助于临床诊断和治疗。