Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy -
Diagnostic Service Department, AORN Dei Colli - V. Monaldi, Naples, Italy.
Minerva Med. 2021 Jun;112(3):338-345. doi: 10.23736/S0026-4806.20.06607-0. Epub 2020 May 14.
The incidence of cancer is higher in transplant patients than in the normal population, mostly due to the assumption of immunosuppressants able to reduce the possibility of rejection. In addition, immunocompromised patients have a greater susceptibility to EBV, HPV and HIV, infectious agents that by themselves may favor the onset of malignancies. Post-transplant lymphoproliferative diseases (PLDs) are among the most frequent neoplasms in transplant patients which like other aggressive neoplasms may be identified by the [18f] fluoro-D-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT).
We evaluated the clinical use of FDG-PET/CT in detecting PTLDs and other neoplasms performed at the lowest clinical or laboratory suspicion of malignancy in 127 consecutive subjects who underwent heart transplantation.
A SUV>4 more confirmed the suspect of malignancy and induced us to further investigations. Of the 127 transplant subjects who underwent FDG-PET/CT, 64 showed a SUV value >4. Of these 64, 8 had PTLDs, 49 other neoplasms (urinary tract tumors, thyroid cancer, HPV cancer related, Kaposi' sarcoma and EBV related head and neck neoplasms) and 7 patients with chronic non-neoplastic inflammatory diseases.
In the present study, FDG-PET/CT examination was of great use for an early identification and for an early treatment of PTLDs and other neoplasms.
移植患者的癌症发病率高于普通人群，这主要是由于假设免疫抑制剂能够降低排斥的可能性。此外，免疫功能低下的患者更容易感染 EBV、HPV 和 HIV 等传染性病原体，这些病原体本身可能导致恶性肿瘤的发生。移植后淋巴组织增生性疾病（PTLDs）是移植患者中最常见的肿瘤之一，与其他侵袭性肿瘤一样，可通过 [18f] 氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）进行识别。
我们评估了 FDG-PET/CT 在检测 PTLDs 和其他肿瘤中的临床应用，这些肿瘤是在 127 例连续接受心脏移植的患者中，在最低的临床或实验室恶性肿瘤怀疑下进行的。
SUV>4 更证实了恶性肿瘤的怀疑，并促使我们进行进一步的检查。在接受 FDG-PET/CT 的 127 例移植患者中，有 64 例 SUV 值>4。在这 64 例患者中，有 8 例患有 PTLDs，49 例患有其他肿瘤（尿路肿瘤、甲状腺癌、HPV 相关癌症、卡波西肉瘤和 EBV 相关头颈部肿瘤），7 例患有慢性非肿瘤性炎症性疾病。
在本研究中，FDG-PET/CT 检查对于早期识别和早期治疗 PTLDs 和其他肿瘤非常有用。
