国际肿瘤学杂志

国际肿瘤学杂志››2025,Vol. 52››Issue (10): 628-632.doi:10.3760/cma.j.cn371439-20250331-00107

• 论著 •上一篇下一篇

18F-FDG PET/CT鉴别回盲部原发性肠弥漫大B细胞淋巴瘤与结肠癌的价值

陈桥梁, 梁迪, 陈静, 何健()

  1. 南京大学医学院附属鼓楼医院核医学科，南京 210008
  • 收稿日期:2025-03-31修回日期:2025-06-09出版日期:2025-10-08发布日期:2025-11-12
  • 通讯作者:何健 E-mail:hjxueren@126.com

Value of18F-FDG PET/CT in differentiating primary intestinal diffuse large B-cell lymphoma from colon cancer in the ileocecal region

Chen Qiaoliang, Liang Di, Chen Jing, He Jian()

  1. Department of Nuclear Medicine， Nanjing Drum Tower Hospital， Affiliated Hospital of Nanjing University Medical School， Nanjing 210008， China
  • Received:2025-03-31Revised:2025-06-09Online:2025-10-08Published:2025-11-12
  • Contact:He Jian E-mail:hjxueren@126.com

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摘要：

目的探讨18F-FDG PET/CT对回盲部原发性肠弥漫大B细胞淋巴瘤（PIDLBCL）与结肠癌的鉴别诊断价值。方法选取2013年6月至2023年12月于南京大学医学院附属鼓楼医院收治的42例回盲部肿瘤患者作为研究对象，其中PIDLBCL 17例、结肠癌 25例。比较回盲部PIDLBCL和结肠癌患者的一般资料及18F-FDG PET/CT参数，采用二元logistic回归分析鉴别诊断回盲部PIDLBCL和结肠癌的独立影响因素。采用受试者操作特征（ROC）曲线评估独立影响因素的诊断效能。结果回盲部PIDLBCL与结肠癌患者间肿瘤长径（Z=-2.63，P=0.009）、最大厚度（Z=-3.26，P=0.001）、累及回肠（χ2=6.04，P=0.014）、肠腔扩张（χ2=10.38，P=0.001）、最大标准化摄取值（SUVmax）（Z=-3.73，P<0.001）、SUVmean（Z=-3.40，P<0.001）、肿瘤代谢体积（Z=-2.37，P=0.018）和病灶糖酵解总量（Z=-2.93，P=0.003）的差异均有统计学意义。多因素分析显示，SUVmax（OR=1.16，95%CI为1.04~1.31，P=0.011）和肠腔扩张（OR=6.64，95%CI为1.13~39.10，P=0.036）均是鉴别诊断回盲部PIDLBCL与结肠癌的独立影响因素。ROC曲线分析显示，SUVmax和肠腔扩张鉴别诊断回盲部PIDLBCL和结肠癌的曲线下面积分别为0.84（95%CI为0.70~0.94）、0.73（95%CI为0.58~0.86），SUVmax的最佳临界值为19.14，敏感性为70.6%，特异性为88.0%，肠腔扩张的敏感性为58.8%，特异性为88.0%。结论18F-FDG PET/CT可用于回盲部PIDLBCL与结肠癌的鉴别诊断，其中SUVmax和肠腔扩张具有较高的诊断效能。

关键词:结肠肿瘤,淋巴瘤，大B细胞，弥漫性,正电子发射断层显像计算机体层摄影术,氟脱氧葡萄糖F18,回盲部

Abstract:

ObjectiveTo investigate the value of18F-fluorodeoxyglucose （18F-FDG） PET/CT in the differential diagnosis of primary intestinal diffuse large B-cell lymphoma （PIDLBCL） and colon cancer in the ileocecal region.MethodsA total of 42 patients with ileocecal tumors admitted to Nanjing Drum Tower Hospital， Affiliated Hospital of Nanjing University Medical School from June 2013 to December 2023 were selected as the study objects， including 17 cases of PIDLBCL and 25 cases of colon cancer. General data and18F-FDG PET/CT parameters were compared between patients with PIDLBCL and colon cancer in the ileocecal region. Binary logistic regression was used to analyze the independent influencing factors for the differential diagnosis of PIDLBCL and colon cancer in the ileocecal region. The receiver operator characteristic （ROC） curve was used to evaluate the diagnostic efficacy of independent influencing factors.ResultsThere were statistically significant differences in tumor length diameter （Z=-2.63，P=0.009）， maximum thickness （Z=-3.26，P=0.001）， ileal involvement （χ2=6.04，P=0.014）， intestinal dilation （χ2=10.38，P=0.001）， maximum standardized uptake value （SUVmax） （Z=-3.73，P<0.001）， SUVmean（Z=-3.40，P<0.001）， metabolic tumor volume （Z=-2.37，P=0.018） and total lesion glycolysis （Z=-2.93，P=0.003） between patients with PIDLBCL and colon cancer in the ileocecal region. Multivariate analysis showed that SUVmax（OR=1.16， 95%CI： 1.04-1.31，P=0.011） and intestinal dilation （OR=6.64， 95%CI： 1.13-39.10，P=0.036） were both independent influencing factors for the differential diagnosis of PIDLBCL and colon cancer in the ileocecal region. ROC curve analysis showed that， the areas under the curve of SUVmaxand intestinal dilation for the differential diagnosis of PIDLBCL and colon cancer in the ileocecal region were 0.84 （95%CI： 0.70-0.94） and 0.73 （95%CI： 0.58-0.86）， respectively. The optimal cut-off value for SUVmaxwas determined to be 19.14， with a sensitivity of 70.6% and a specificity of 88.0%， while intestinal dilation exhibited a sensitivity of 58.8% and a specificity of 88.0%.Conclusions18F-FDG PET/CT can be used for the differential diagnosis of PIDLBCL and colon cancer in the ileocecal region， and SUVmaxand intestinal dilation have high diagnostic efficacy.

Key words:Colonic neoplasms,Lymphoma， large B-cell， diffuse,Positron emission tomography computed tomography,Fluorodeoxyglucose F18,Ileocecal region

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