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目的探讨原发性胃弥漫大B细胞淋巴瘤(PGDLBCL)和胃腺癌(GA)之间的18氟-脱氧葡萄糖-正电子发射体层显像/电子计算机断层扫描术(18F-FDG PET/CT)的表现特征对比。方法回顾性分析2008年5月至2014年5月经胃镜或手术病理证实的22例PGDLBCL患者和34例GA患者的临床和PET/CT图像资料,对病灶的CT表现、最大标准摄取值(SUVmax)、最大厚度(THKmax)及胃周浸润、淋巴结受累情况等进行对比分析,并对其分型进行比较。结果 PGDLBCL及GA在PET/CT上表现为不同形式的胃壁增厚和FDG代谢的显著增高。剔除肿瘤厚度的影响后,PGDLBCL的SUVmax(20.67±8.76)显著高于GA的SUVmax(8.68±6.00),差异有统计学意义(t=5.335,P=0.000);胃部病灶THKmax在PGDLBCL(4.10±1.98)cm和GA(3.28±2.34)cm之间无统计学差异(t=0.903,P=0.376)。同时PGDLBCL的胃壁增厚和SUVmax之间无相关性(r=0.372,P=0.325),而GA的胃壁增厚和SUVmax之间有很好的相关性(r=0.721,P=0.002)。18F-FDG PET/CT显像中PGDLBCL的表现以Ⅰ型(27.27%)和Ⅱ型(59.09%)较多,而胃腺癌则以Ⅱ型(52.94%)和Ⅲ型(35.29%)多见。以病变范围最广层面测量,PGDLBCL中病灶侵犯胃周径>50%的发生率68.18%明显高于GA的17.65%(χ2=14.554,P=0.000)。结论根据18FFDG PET/CT图像分析,借助SUVmax及分型比较,可较好地诊断和鉴别诊断PGDLBCL和GA;同时其也可反映PGDLBCL的生物学和病理学特征,为临床诊治提供参考依据。
Objective To investigate the diagnostic value of 18F-FDG PET / CT in primary gastric diffuse large B-cell lymphoma (PGDLBCL) and gastric adenocarcinoma (GA) by fluorodeoxyglucose-positron emission tomography ) Performance characteristics of contrast. Methods The clinical and PET / CT images of 22 patients with PGDLBCL and 34 patients with GA confirmed by endoscopy or surgical pathology from May 2008 to May 2014 were retrospectively analyzed. The CT findings, maximum standard uptake value (SUVmax) , The maximum thickness (THKmax) and gastric perivascular infiltration, lymph node involvement and other comparative analysis, and its classification were compared. Results PGDLBCL and GA showed different forms of gastric wall thickening and FDG metabolism in PET / CT. After excluding the influence of tumor thickness, the SUVmax of PGDLBCL was significantly higher than that of GA (8.66 ± 8.76), the difference was statistically significant (t = 5.335, P = 0.000) ± 1.98) cm and GA (3.28 ± 2.34) cm. There was no significant difference (t = 0.903, P = 0.376). There was no correlation between PGDLBCL and SUVmax (r = 0.372, P = 0.325). There was a good correlation between GA wall thickness and SUVmax (r = 0.721, P = 0.002). In 18F-FDG PET / CT imaging, the expression of PGDLBCL was more frequent in type Ⅰ (27.27%) and type Ⅱ (59.09%) than in type Ⅱ (52.94%) and type Ⅲ (35.29%). In the widest range of lesions, the incidence of gastric peripheral lesions> 50% in PGDLBCL was 68.18% higher than that in GA 17.65% (χ2 = 14.554, P = 0.000). Conclusions According to 18FFDG PET / CT image analysis, the diagnosis and differential diagnosis of PGDLBCL and GA can be performed well with the help of SUVmax and classification. At the same time, it can also reflect the biological and pathological features of PGDLBCL and provide a reference for clinical diagnosis and treatment.