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F-FDG PET/CT检测皮下软组织转移的临床价值及生存分析

Clinical value and survival analysis of subcutaneous soft tissue metastasis detected by F-FDG PET/CT.

作者信息

Gao Yufei, Zhang Hui, Hao Tiancheng, Jia Lizhuo, Wu Jiangmeng, Wu Dongxue, Wu Siqi, Wang Yong

机构信息

Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Medical Imaging, Hebei General Hospital, Shijiazhuang, Hebei, China.

出版信息

Front Oncol. 2025 Apr 2;15:1561137. doi: 10.3389/fonc.2025.1561137. eCollection 2025.

Abstract

OBJECTIVE

To retrospectively analyze cases of whole-body F-FDG PET/CT imaging, identify abnormal images of subcutaneous nodules, and explore the clinical application value of PET/CT in detecting subcutaneous soft tissue metastases and its impact on survival.

METHOD

An analysis was conducted on cases from August 2019 to August 2024, and 57 cases of subcutaneous nodules were found to have positive 18F-FDG imaging, all of which underwent pathological puncture or biopsy. Collect patient histological subtypes, metastasis patterns, treatment, and survival rates. Kaplan Meier curves were used to estimate survival time, and Mantel-Cox univariate analysis was used to determine the correlation between extensive metastasis, degree of soft tissue involvement, systemic and local treatment, and survival time.

RESULT

Among the 57 patients confirmed by pathology, 10 were benign and 47 were malignant. Among 47 cases of malignant tumors, 39 cases were postoperative cases, 8 cases were preoperative cases, and 4 cases had unknown primary lesions. A total of 88 subcutaneous lesions were found, including 28 patients with a single lesion, 12 patients with two lesions, and 8 patients with three or more lesions. One patient with unknown primary lesion reported abdominal wall nodules as the main symptom. PET/CT assisted in qualitative localization in 11 cases. Univariate analysis showed that the median survival time (22 months) of patients who did not receive local radiotherapy was significantly shorter than that of patients who did receive local radiotherapy (60 months) (P<0.05). There is no correlation between gender, metastasis pattern, metastasis at initial diagnosis, use of chemotherapy, and survival time.

CONCLUSION

Whole body PET/CT imaging has important application value in the diagnosis of subcutaneous soft tissue metastasis. By comprehensively evaluating the patient's overall condition and accurately determining whether there is a simple soft tissue metastasis, local intervention measures can bring more favorable prognosis for patients with good general condition and only soft tissue metastasis.

摘要

目的

回顾性分析全身F-FDG PET/CT成像病例,识别皮下结节的异常图像,探讨PET/CT在检测皮下软组织转移中的临床应用价值及其对生存的影响。

方法

对2019年8月至2024年8月的病例进行分析,发现57例皮下结节18F-FDG成像呈阳性,均接受了病理穿刺或活检。收集患者的组织学亚型、转移模式、治疗情况及生存率。采用Kaplan Meier曲线估计生存时间,采用Mantel-Cox单因素分析确定广泛转移、软组织受累程度、全身及局部治疗与生存时间之间的相关性。

结果

57例经病理确诊的患者中,10例为良性,47例为恶性。47例恶性肿瘤中,39例为术后病例,8例为术前病例,4例原发灶不明。共发现88个皮下病灶,其中单发病灶患者28例,两个病灶患者12例,三个及以上病灶患者8例。1例原发灶不明患者以腹壁结节为主要症状。PET/CT辅助定性定位11例。单因素分析显示,未接受局部放疗患者的中位生存时间(22个月)明显短于接受局部放疗患者(60个月)(P<0.05)。性别、转移模式、初诊时转移、化疗使用与生存时间之间无相关性。

结论

全身PET/CT成像在皮下软组织转移诊断中具有重要应用价值。通过全面评估患者整体状况,准确判断是否存在单纯软组织转移,对于一般状况良好且仅存在软组织转移的患者,局部干预措施可带来更有利的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79f6/11999822/3ff49d660c11/fonc-15-1561137-g001.jpg

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