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目的探讨18F-氟脱氧葡萄糖(18F-FDG)PET-CT对分化型甲状腺癌(DTC)肺转移病灶的诊断和疗效评价的价值。方法收集2006年7月至2010年12月上海交通大学附属第六人民医院对38例DTC肺转移患者行18F-FDG PET-CT、131I全身扫描(131I-WBS)检查,并随访,了解患者肺内病灶变化及预后情况。结果18F-FDG PE-CT、131I-WBS共发现肺内病灶68个,45个病灶131I-WBS阳性、18F-FDG PET-CT呈阴性,19个病灶18F-FDG PET-CT阳性、131I-WBS阴性;4个病灶两种检查均为阴性,两者联合检测的灵敏度为94.11%,而在131I-WBS阴性的患者中18F-FDG PET-CT阳性率为82.61%。18F-FDG PET-CT对DTC肺内转移灶的检出率与患者血清促甲状腺激素水平密切相关。结论131I-WBS联合18F-FDG PET-CT在探测DTC转移病灶时具有重要的临床价值,明显优于各自独立应用的结果。DTC细胞对18F-FDG的摄取与肿瘤细胞的分化程度相关,对指导治疗和预后的判断有重要作用。
Objective To investigate the value of 18F-FDG PET-CT in the diagnosis and treatment of differentiated thyroid cancer (DTC) with lung metastases. Methods 18F-FDG PET-CT and 131I whole-body scanning (131I-WBS) were performed in 38 DTC patients with lung metastasis from July 2006 to December 2010 at the Sixth People’s Hospital affiliated to Shanghai Jiaotong University. All the patients were followed up Intra-lesion changes and prognosis. RESULTS: There were 68 lung lesions in 18F-FDG PE-CT and 131I-WBS, 45 lesions were positive for 131I-WBS, 18F-FDG PET-CT was negative, 19 lesions were positive for 18F-FDG PET-CT, Negative; 4 lesions were negative for both tests, the combined detection of the two 94.11% sensitivity, and in patients with negative 131I-WBS 18F-FDG PET-CT positive rate was 82.61%. 18F-FDG PET-CT detection of DTC lung metastases and serum thyrotropin levels are closely related. Conclusion 131I-WBS combined with 18F-FDG PET-CT has important clinical value in detecting DTC metastasis, which is obviously superior to the results of independent application. The uptake of 18F-FDG by DTC cells correlates with the differentiation of tumor cells and plays an important role in guiding the treatment and prognosis.