PET-CT在非小细胞肺癌诊疗中的应用

摘要/Abstract

摘要：18F-氟脱氧葡萄糖正电子发射计算机断层显像（PET-CT）对肺癌的治疗愈加重要，与CT相比，PET-CT具有明显的优势，其对转移灶的确定、对炎症的鉴别准确性更高，并且PET-CT在准确分期的基础上，改变了很多由传统影像确定的治疗方式，提高了治疗效果。对治疗后效果的评估与预测，对治疗策略的制定也产生重要影响。

关键词:癌,非小细胞肺,氟脱氧葡萄糖F18,体层摄影术,发射型计算机,体层摄影术,X线计算机

Abstract:PET-CT plays a increasing important role in the treatment of lung cancer. Compared with CT, the advantage of PET-CT is obvious, which is more accuracy when determine a metastasis and identify inflammatory lesions. What′s more, on the basis of the accuracy staging, PET-CT change many strategies which were based on traditional image, resulting in improving the treatment effect. While the assessment and prediction of the efficacy by PET-CT also exerted an important influence on the formulation of treatment strategies.

Key words:Carcinoma, nonsmallcell lung,Fluorodeoxyglucose F18,Positronemission tomography,Tomography,Xray computed

赵向荣, 张永, 于甬华. PET-CT在非小细胞肺癌诊疗中的应用[J]. 国际肿瘤学杂志, 2016, 43(2): 133-.

ZHAO Xiang-Rong, ZHANG Yong, YU Yong-Hua. The advances in diagnosis and treatment of nonsmall cell lung cancer with PET-CT[J]. Journal of International Oncology, 2016, 43(2): 133-.

参考文献

［1］ Cuaron J, Dunphy M, Rimner A. Role of FDGPET scans in staging, response assessment, and followup care for nonsmall cell lung cancer［J］. Front Oncol, 2013, 2: 208213. DOI:10.3389/fonc.2012.00208. ［2］朱有才, 杜开齐, 余党凡，等. 18FFDG PETCT在肺部良、恶性病变中的诊断应用［J］. 实用肿瘤杂志, 2007, 22(5): 461463. ［3］ Abe K, Baba S, Kaneko K, et al. Diagnostic and prognostic values of FDGPET in patients with nonsmall cell lung cancer［J］. Clin Imaging, 2009, 33(2): 9095. DOI:10.1016/j.clinimag.2008.06.032 . ［4］ Kim SK, AllenAuerbach M, Goldin J, et al. Accuracy of PET/CT in characterization of solitary pulmonary lesions［J］. J Nucl Med, 2007, 48(2): 214220. ［5］ Imai K, Minamiya Y, Saito H, et al. Diagnostic imaging in the preoperative management of lung cancer［J］. Surg Today, 2014, 44(7): 11971206. DOI:10.1007/s005950130660z. ［6］ De Wever W, Ceyssens S, Mortelmans L, et al. Additional value of PETCT in the staging of lung cancer: Comparison with CT alone, PET alone and visual correlation of PET and CT［J］. Eur Radiol, 2007, 17(1)： 2332. DOI:10.1007/s0033000602844. ［7］ Chao F, Zhang H. PET/CT in the staging of the nonsmallcell lung cancer［J］. J Biomed Biotechnol, 2012, 2012, 783739. DOI:10.1155/2012/783739. ［8］ Shim SS, Lee KS, Kim BT, et al. Nonsmall cell lung cancer: prospective comparison of integrated FDG PET/CT and CT alone for preoperative staging［J］. Radiology, 2005, 236(3): 10111019. DOI:10.1148/radiol.2363041310. ［9］ Billé A, Pelosi E, Skanjeti A, et al . Preoperative intrathoracic lymph node staging in patients with nonsmallcell lung cancer: accuracy of integrated positron emission tomography and computed tomography［J］. Eur J Cardiothorac Surg, 2009, 36(3)： 440445. DOI:10.1016/j.ejcts.2009.04.003. ［10］ Liu N, Ma L, Zhou W, et al. Bone metastasis in patients with nonsmall cell lung cancer: The diagnostic role of F18FDG PET/CT［J］. Eur J Radiol, 2010, 74(1): 231235. DOI:10.1016/j.ejrad.2009.01.036. ［11］ Ettinger DS, Akerley W, Bepler G, et al. Nonsmall cell lung cancer［J］. J Natl Compr Canc Netw, 2010, 8(7): 740801. ［12］ Verhagen AF, Bootamab GP, TjanHeijnen VC, et al . FDGPET in staging lung cancer: How does it change the algorithm?［J］. Lung Cancer, 2004, 44(2): 175181. DOI:10.1016/j.lungcan.2003.11.007. ［13］ Rizzo G, Cattaneo GM, Castellone P, et al . Multimodal medical image integration to optimize radiotherapy planning in lung cancer treatment［J］. Ann Biomed Eng, 2004, 32(10): 13991408. ［14］ Mutlu H, Buyukcelik A, Erden A, et al . Staging with PETCT in patients with locally advanced non small cell lung cancer is superior to conventional staging methods in terms of survival［J］. Asian Pac J Cancer Prev, 2013, 14(6): 37433746. ［15］ Abramyuk A, Appold S, Zphel K, et al . Quantitative modificationgs of TNM staging,clinical staging and therapeutic intent by FDGPET/CT in patients with nonsmall cell lung cancer scheduled for radiotherapy—a retrospective study［J］. Lung Cancer, 2012, 78(2): 148152. DOI:10.1016/j.lungcan.2012.08.001. ［16］ Machtay M, Duan F, Siegel BA, et al . Prediction of survival by ［18F］fluorodeoxyglucose positron emission tomography in patients with locally advanced nonsmall cell lung cancer undergoing definitive chemoradiation therapy :results of the ACRIN 6668/RTOG 0235 trial［J］. J Clin Oncol, 2013, 31(30): 38233830. DOI:10.1200/JCO.2012.47.5947. ［17］ Hoekstra CJ, Stroobants SG, Smit EF, et al . Prognostic relevance of response evaluation using 18F2fluoro2deoxydglucose positron emission tomography in patients with locally advanced nonsmallcell lung cancer［J］. J Clin Oncol, 2005, 23(33): 83628370. ［18］ Lee DH, Kim S, Lee HY, et al . Early prediction of response to firstline therapy using integrated 18FFDG PET/CT for patients with advanced/metastatic nonsmall cell lung cancer［J］. J Thorac Oncol, 2009, 4(7): 816821. DOI:10.1097/JTO.0b013e3181a99fde. ［19］ Huang W, Zhou T, Ma L, et al . Standard uptake value and metabolic tumor volume of 18FFDG PET/CT predict shortterm outcome early in the course of chemoradiotherapy in advanced nonsmall cell lung cancer［J］. Eur J Nucl Med Mol Imaging, 2011, 38(9): 16281635. DOI:10.1007/s0025901118385. ［20］ van Elmpt W, Ollers M, Dingemans AM, et al. Response assessment using 18FFDG PET early in the course of radiotherapy correlates with survival in advancedstage nonsmall cell lung cancer［J］. J Nucl Med, 2012, 53(10): 15141520. DOI:10.2967/jnumed.111.102566. ［21］张华琦, 于金明, 孟雪，等. 18F氟脱氧葡萄糖PETCT显像预测Ⅲ期非小细胞肺癌的预后［J］．中华肿瘤杂志, 2012, 32(8): 603606. ［22］ Benz MR, Herrmann K, Walter F, et al . (18)FFDG PET/CT for monitoring treatment responses to the epidermal growth factor receptor inhibitor erlotinib ［J］. J Nucl Med, 2011, 52(11): 16841689. DOI:0.2967/jnumed.111.095257. ［23］ Aukema TS, Kappers I, Olmos RA, et al. Is 18FFDG PET/CT useful for the early prediction of histopathologic response to neoadjuvant erlotinib in patients with nonsmall cell lung cancer?［J］. J Nucl Med, 2010, 51(9): 13441348. DOI:10.2967/jnumed.110.076224. ［24］ Mileshkin L, Hicks RJ, Hughes BG, et al . Changes in 18Ffluorodeoxyglucose and 18Ffluorodeoxythymidine positron emission tomography imaging in patients with nonsmall cell lung cancer treated with erlotinib［J］. Clin Cancer Res, 2011, 17(10): 33043315. DOI:10.1158/10780432.CCR102763. ［25］ Zander T, Scheffler M, Nogova L, et al. Early prediction of nonprogression in advanced nonsmallcell lung cancer treated with erlotinib by using ［(18)F］fluorodeoxyglucose and ［(18)F］fluorothymidine positron emission tomography［J］. J Clin Oncol, 2011, 29(13): 17011708. DOI:17011708. 10.1200/JCO.2010.32.4939. ［26］ Puranik AD, Purandare NC, Shah S, et al . Role of FDG PET/CT in assessing response to targeted therapy in metastatic lung cancers: Morphological versus metabolic criteria［J］. Indian J Nucl Med, 2015, 30(1): 2125. DOI:10.4103/09723919.147529. ［27］ Calais J, Thureau S, Dubray B, et al. Areas of high 18FFDG uptake on preradiotherapy PET/CT identify preferential sites of local relapse after chemoradiotherapy for nonsmall cell lung cancer［J］. J Nucl Med, 2015, 56(2):196203. DOI:10.2967/jnumed.114.144253. ［28］ Machtay M, Paulus R, Moughan J, et al . Defining localregional control and its importance in locally advanced nonsmall cell lung carcinoma［J］. J Thorac Oncol, 2012, 7(4): 716722. DOI:10.1097/JTO.0b013e3182429682. ［29］ Truong MT, Pan T, Erasmus JJ. Pitfalls in integrated CTPET of the thorax: implications in oncologic imaging［J］. J Thorac Imaging, 2006, 21(2): 111122. ［30］ Ikushima H, Dong L, Erasmus J, et al . Predictive value of 18F fluorodeoxyglucose up take by positron emission tomography for nonsmall cell lung cancer patients treated with radical radiotherapy［J］. J Radiat Res, 2010, 51(4): 465471. ［31］魏雪梅, 张云, 杨晓红, 等. 18FFDG PETCT 诊断肺部病变的误诊分析［J］．临床肺科杂志, 2012, 17(8): 14011403．［32］ Zhu SH, Zhang Y, Yu YH, et al . FDG PETCT in nonsmall cell lung cancer: relationship between primary tumor FDG uptake and extensional or metastatic potential［J］. Asian Pac J Cancer Prev, 2013, 14(5): 29252929. ［33］ Svik A, Malinen E, Olsen DR. Adapting biological feedback in radiotherapy［J］. Semin Radiat Oncol, 2010, 20(2): 138146. DOI:10.1016/j.semradonc.2009.11.008.

[1]	钱晓涛, 石子宜, 胡格, 吴晓维.Ⅲ~ⅣA期食管鳞状细胞癌放化疗后行巩固化疗的疗效：一项真实世界临床研究[J]. 国际肿瘤学杂志, 2024, 51(6): 326-331.
[2]	郭泽浩, 张俊旺.PFDN及其亚基在肿瘤发生发展中的作用[J]. 国际肿瘤学杂志, 2024, 51(6): 350-353.
[3]	王丽, 刘志华, 杨伟洪, 蒋凤莲, 李全泳, 宋浩杰, 鞠文东.ROS1突变肺腺鳞癌合并脑梗死为主要表现的Trousseau综合征1例[J]. 国际肿瘤学杂志, 2024, 51(6): 382-384.
[4]	范志鹏, 余静, 胡静, 廖正凯, 徐禹, 欧阳雯, 谢丛华.炎症标志物的变化趋势对一线接受免疫联合化疗的晚期非小细胞肺癌患者预后的预测价值[J]. 国际肿瘤学杂志, 2024, 51(5): 257-266.
[5]	王俊毅, 洪楷彬, 纪荣佳, 陈大朝.癌结节对结直肠癌根治性切除术后肝转移的影响[J]. 国际肿瘤学杂志, 2024, 51(5): 280-285.
[6]	顾芳萌, 徐晨阳, 雷大鹏.人工智能辅助电子喉镜检查在喉癌及喉癌前病变诊治中的研究进展[J]. 国际肿瘤学杂志, 2024, 51(5): 303-307.
[7]	张文馨, 夏泠, 彭晋, 周福祥.甲胎蛋白升高型胃肝样腺癌1例并文献复习[J]. 国际肿瘤学杂志, 2024, 51(5): 312-315.
[8]	王昆, 周中新, 臧其威.血清TGF-β1、VEGF水平对非小细胞肺癌患者单孔胸腔镜根治术后复发的预测价值[J]. 国际肿瘤学杂志, 2024, 51(4): 198-203.
[9]	杨毫, 施贵冬, 张程城, 张跃, 张力文, 付茂勇.信迪利单抗与替雷利珠单抗在进展期食管鳞状细胞癌新辅助治疗中的疗效及安全性对比[J]. 国际肿瘤学杂志, 2024, 51(4): 210-216.
[10]	姚益新, 沈煜霖.血清SOCS3、TXNIP水平对肝细胞癌TACE治疗预后的预测价值[J]. 国际肿瘤学杂志, 2024, 51(4): 217-222.
[11]	胡婷婷, 王越华.电子鼻与线虫鼻——新型早期癌症筛查工具[J]. 国际肿瘤学杂志, 2024, 51(4): 223-226.
[12]	张栋岩, 王品, 魏秋亚, 邓成伍, 魏相相, 高远飞, 王琛.索凡替尼靶向联合卡培他滨和奥沙利铂治疗肝内胆管癌术后患者1例及文献复习[J]. 国际肿瘤学杂志, 2024, 51(4): 249-253.
[13]	严爱婷, 王翠竹, 刘春桂, 鲁小敏.卡瑞利珠单抗与信迪利单抗治疗晚期非小细胞肺癌的临床疗效及安全性分析[J]. 国际肿瘤学杂志, 2024, 51(3): 137-142.
[14]	孙维蔚, 姚学敏, 王鹏健, 王静, 贾敬好.基于血液学指标探讨免疫治疗晚期非小细胞肺癌预后因素及列线图构建[J]. 国际肿瘤学杂志, 2024, 51(3): 143-150.
[15]	钱晓涛, 石子宜, 胡格.Ⅲ~ⅣA期食管鳞状细胞癌根治性放化疗后行免疫检查点抑制剂维持治疗的真实世界临床研究[J]. 国际肿瘤学杂志, 2024, 51(3): 151-156.