| 李娟,双江,高强,等.以 18F-氟代脱氧葡萄糖为显像剂的正电子发射计算机断层显像的代谢参数与甲状腺激素联合在非小细胞肺癌诊断中的应用[J].安徽医药,2026,30(11):2233-2237. |
| 以 18F-氟代脱氧葡萄糖为显像剂的正电子发射计算机断层显像的代谢参数与甲状腺激素联合在非小细胞肺癌诊断中的应用 |
| Application of metabolic parameters of 18F-FDG PET/CT combined with thyroid hormones in the diagnosis of non-small cell lung cancer |
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| DOI：10.3969/j.issn.1009-6469.2026.11.021 |
| 中文关键词: 癌，非小细胞肺 氟 脱氧葡萄糖 正电子发射计算机断层显像 放射性药物 代谢参数 甲状腺激素 诊断 |
| 英文关键词: Carcinoma, non-small-cell lung Fluorine FDG roid hormone Diagnosis |
| 基金项目:榆林市科技计划项目( 20210362) |
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| 中文摘要: |
| 目的探究以 18F-氟代脱氧葡萄糖( 18F-FDG)为显像剂的正电子发射计算机断层显像( PET/CT)的代谢参数与甲状腺激素联合在非小细胞肺癌( NSCLC)诊断中的应用。方法选取 2023年 1月至 2024年 3月榆林市第一医院就诊的 NSCLC病人(NSCLC组) 110例作为研究对象，另取同期肺部良性肿瘤病变病人 110例作为对照组。收集所有受试者的临床资料；使用 18F-FDG PET/CT扫描系统检测所有受试者的代谢参数；使用全自动化学发光免疫分析仪测量所有受试者的甲状腺激素水平； logistic多因素分析影响 NSCLC发生的因素；受试者操作特征曲线( ROC曲线)分析 18F-FDG PET/CT的代谢参数与甲状腺激素对 NSCLC的诊断价值。结果 NSCLC病人中有油烟接触史( 69.09%比 55.45%)、吸烟史( 68.18%比 53.64%)、饮酒史占比(76.36%比 61.82%)及细胞角蛋白 19片段( Cyfra 21-1)［( 31.97±4.27)μg/L比( 2.94±0.53)μg/L］、最大标准化摄取值( SUVmax)［( 5.42±1.76)g/cm2比( 4.21±1.39)g/cm2］、肿瘤代谢体积( MTV)［( 4.86±1.54)cm2比( 3.74±1.13)cm2］和病灶糖酵解总量( TLG)［( 13.36±4.51)g比( 9.98±2.87)g］、促甲状腺素( TSH)［( 3.98±1.31)mIU/L比( 3.07±0.98)mIU/L］显著高于对照组，游离三碘甲状腺原氨酸( FT3)水平［( 3.44±0.62)pmol/L比( 3.98±0.76)pmol/L］显著低于对照组( P<0.05)。油烟接触史、吸烟史、饮酒史、 Cyfra 21-1、SUVmax、MTV、TLG、TSH是影响 NSCLC发生的危险因素， FT3是影响 NSCLC发生的保护因素(P<0.05)。 SUVmax、MTV、TLG、 FT3、TSH水平以及联合诊断 NSCLC的 AUC分别为 0.75、0.70、0.67、0.70、0.79和 0.91，联合诊断优于各自单独诊断( Z联合 -SUVmax=5.44、Z联合 -MTV=5.78，Z联合 -TLG=6.57、Z联合 -FT3=5.76，Z联合 -TSH=4.24，P<0.05)。结论 NSCLC病人的 18F-FDG PET/CT的代谢参数 SUVmax、MTV、TLG以及甲状腺激素中 TSH水平明显升高， FT3明显降低，其均与 NSCLC的发病相关，且联合检测对 NSCLC的诊断价值优于各自单独诊断。 |
| 英文摘要: |
| Objective To investigate the application of metabolic parameters of positron emission computed tomography (18F-FDG PET/CT) with fluorine (18F) deoxyglucose as imaging agent combined with thyroid hormone in the diagnosis of non-small cell lung can-cer (NSCLC).Methods A total of 110 NSCLC patients (NSCLC group) who visited the First Hospital of Yulin from January 2023 toMarch 2024 were used as the study subjects, and another 110 patients with benign lung tumor lesions were selected as the controlgroup.Clinical data of all subjects were collected. The 18F-FDG PET/CT scanning system was applied to detect metabolic parameters ofall subjects. Fully automated immune luminescence analyzer was applied to measure the thyroid hormone levels of all subjects. Logisticmultivariate analysis was applied to analyze the factors that affected the occurrence of NSCLC. ROC curve was applied to analyze themetabolic parameters of 18F-FDG PET/CT and the diagnostic value of thyroid hormones for NSCLC.Results The proportion of history of kitchen fume exposure (69.09% vs. 55.45%), history of smoking (68.18% vs. 53.64%), history of alcohol consumption (76.36% vs. 61.82%),and the cytokeratin 19 fragment (Cyfra 21-1)[(31.97±4.27)μg/L vs. (2.94±0.53)μg/L], standard uptake value (SUVmax)[(5.42± 1.76)g/cm2 vs. (4.21±1.39)g/cm2], metabolic tumor volume (MTV) [(4.86±1.54)cm2 vs. (3.74±1.13)cm2], total lesion glycolysis (TLG) [(13.36±4.51)g vs. (9.98±2.87)g], and level of thyroid stimulating hormone (TSH) [(3.98±1.31)mIU/L vs. (3.07±0.98)mIU/L] of NSCLCpatients were greatly higher than those in the control group, while the level of free triiodothyronine (FT3)[(3.44±0.62)pmol/L vs. (3.98± 0.76)pmol/L] was greatly lower than that in the control group (P<0.05). History of kitchen fume exposure, history of smoking, history of alcohol consumption, Cyfra 21-1, SUVmax, MTV, TLG, TSH were risk factors affecting the occurrence of NSCLC, while FT3 was a protec-tive factor affecting the occurrence of NSCLC (P<0.05). The AUC of levels of SUVmax, MTV, TLG, FT3, TSH, and their combination indiagnosing NSCLC was 0.75,0.70,0.67,0.70,0.79 and 0.91, respectively, the combined diagnosis was superior to individual diagnosis (Zcombination -UVmax=5.44, Zcombination -MTV=5.78, Z combination -TLG=6.57, Zcombination -FT3=5.76, Z combination -TSH=4.24, P<0.05).Conclusions The metabolic parameters SUVmax, MTV, and TLG of 18F-FDG PET/CT, and the thyroid hormone TSH level in NSCLC patients are greatly increased,while FT3 is greatly decreased, all of which are associated with the onset of NSCLC. The diagnostic value of combined detection for NSCLC is better than that of individual diagnosis. |
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