18F-FDG PET/CT显像在乳腺外Paget病中的临床应用

doi:10.12117/jccmi.2020.08.015

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摘要目的：探讨18F-FDG PET/CT在乳腺外Paget病（Extramammary Paget’s disease，EMPD）诊断、分期和随访中的作用。方法：回顾性分析13例新诊断或可疑复发的EMPD患者全身18F-FDG PET/CT图像。18F-FDG摄取增加的病灶为阳性，测量最大标准摄取值（SUVmax）。结果：13例EMPD患者中，11例术前接受18F-FDG PET/CT检查，2例术后接受18F-FDG PET/CT检查。13例患者中有11例存在皮肤病变，所有皮肤病变18F-FDG摄取均可见不同程度增高，SUVmax介于1.4～15.9之间。其中，皮肤病变的厚度≥1 cm的有4例（4/11），SUVmax介于4.6～15.9之间；<1 cm的有7例（7/11），SUVmax介于1.4～3.9之间。采用独立样本t检验对两组皮肤病变的SUVmax进行统计学比较，结果显示t=2.821，P=0.064，差异无统计学意义。13例EMPD患者发现淋巴结转移7例（7/13），SUVmax介于3.4～15.1之间，其中包含1例EMPD术后及放疗后疑似复发的患者。13例EMPD患者发现远处转移2例（1例为单发骨转移，1例为肺、肝、骨多发转移），所有病灶均表现为18F-FDG不同程度摄取增高，SUVmax介于3.8～14.0之间。同时发现2例EMPD患者合并有肺癌或结肠癌。结论：18F-FDG PET/CT对EMPD的诊断主要依赖于病变的厚度，对转移的诊断更为敏感，因此有助于EMPD的术前分期及临床随访。

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	柳伟坤
	周旋
	彭李
	王鹏龙
	段玉姣
	成蕾
	尹吉林

关键词 ：皮肤肿瘤, 氟脱氧葡萄糖F18, 正电子发射断层显像术

Abstract：Objective: To investigate the role of 18F-FDG PET/CT in the diagnosis, staging and follow-up of extramammary Paget’s disease(EMPD). Methods: Whole-body 18F-FDG PET/CT images of 13 patients with newly diagnosed or suspected recurrent EMPD were retrospectively analyzed. The lesions with increased uptake of 18F-FDG were positive and were measured with maximum standard uptake(SUVmax). Results: Among the 13 patients with EMPD, 11 received 18F-FDG PET/CT before surgery and 2 received 18F-FDG PET/CT after surgery. Eleven patients had skin lesions, 18F-FDG uptake of all skin lesions was increased in varying degrees, SUVmax ranged from 1.4 to 15.9. The skin lesions thickness was more than or equal to 1 cm in 4 cases(4/11), and SUVmax ranged from 4.6 to 15.9, the thickness was less than 1 cm in 7 cases(7/11), and SUVmax ranged from 1.4 to 3.9. The SUVmax of skin lesions between two groups was compared by independent sample t-test and the results showed that t=2.821, P=0.064, without statistical significance. Lymph node metastasis was found in 7(7/13), and SUVmax ranged from 3.4 to 15.1, and one of them(1/7) was suspected recurrence after EMPD surgery and radiotherapy. In 13 EMPD patients, distant metastasis was found in 2 cases(1 case with single bony metastasis, 1 case with multiple lung, liver and bone metastases), all lesions showed increased FDG uptake in varying degrees and SUVmax ranged from 3.8 to 14.0. Two cases(2/13) of EMPD with lung cancer or colon cancer were found. Conclusion: 18F-FDG PET/CT diagnosis of EMPD mainly depends on the thickness of the lesion, which is more sensitive to the diagnosis of metastasis. Therefore, 18F-FDG PET/CT is very useful for the diagnosis, staging and follow-up of EMPD.

Key words： Skin neoplasms Fluorodeoxyglucose F18 Positron-emission tomography

收稿日期: 2020-01-07

PACS:	Ｒ739.5
	Ｒ817.4

通讯作者: 柳伟坤，高尚医学影像诊断中心，510017。E-mail：liuweikun@163.com

作者简介: 柳伟坤（1982-），男，广东汕头人，主治医师。E-mail：liuweikun@163.com

引用本文:

柳伟坤，周旋，彭李，王鹏龙，段玉姣，成蕾，尹吉林. 18F-FDG PET/CT显像在乳腺外Paget病中的临床应用[J]. 中国临床医学影像杂志, 2020, 31(8): 588-591.
LIU Wei-kun, ZHOU Xuan, PENG Li, WANG Peng-long, DUAN Yu-jiao, CHENG Lei, YIN Ji-lin. Clinical application of 18F-FDG PET/CT in extramammary Paget’s disease. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(8): 588-591.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.08.015 或 http://www.jccmi.com.cn/CN/Y2020/V31/I8/588

[1]王荣福，于明明. PET/CT在肿瘤临床中的应用价值[J]. 肿瘤学杂志，2009，15（1）：77-79. [2]齐秀萍，王勤奋，宋述强，等. 18F-FDG PET/CT显像诊断恶性肿瘤的价值[J]. 广西医学，2010，32（4）：413-415. [3]Wagner G, Sachse MM. Extramammary Paget disease-clinical appearance, pathogenesis, management[J]. J Dtsch Dermatol Ges, 2011, 9(6): 448-454. [4]Singh B, Ezziddin S, Palmedo H, et al. Preoperative 18F-FDG-PET/CT imaging and sentinel node biopsy in the detection of regional lymph node metastases in malignant melanoma[J]. Melanoma Res, 2008, 18(5): 346-352. [5]Barsky M, Cherkassky L, Vezeridis M, et al. The role of preoperative positron emission tomography/computed tomography(PET/CT) in patients with high-risk melanoma[J]. J Surg Oncol, 2014, 109(7): 726-729. [6]Zhu Y, Ye DW, Yao XD, et al. Clinicopathological characteristics, management and outcome of metastatic penoscrotal extramammary Paget’s disease[J]. Br J Dermatol, 2009, 161(3): 577-582. [7]Treglia G, Giovannini E, Bertagna F, et al. Anunusual case of metastatic extramammary Paget’s disease of the vulva identified by 18F-FDG PET/CT[J]. Rev Esp Med Nucl Imagen Mol, 2013, 32(6): 402-403. [8]Tian Y, Wu HB, Li DL, et al. Utility of 18F-FDG PET/CT in the diagnosis and staging of extramammary Paget’s disease[J]. Nucl Med Commun, 2015, 36(9): 892-897. [9]范岩，张建华，付占立，等. 18F-FDG PET/CT在乳腺外Paget病分期及随访中的应用（附11例报道）[J]. 中国医学影像技术，2015，31（12）：1898-1901. [10]王剑杰，周鑫，李立伟. 阴囊Paget病18F-FDG PET/CT显像二例[J]. 中华核医学与分子影像杂志，2013，33（3）：233-234. [11]李建芳，程木华，许杰华，等. 乳房外Paget’s病18F-FDG符合线路显像2例[J]. 中国临床医学影像杂志，2011，22（1）：68-69. [12]赵芬，张秀丽，孙晓蓉，等. 18F-FDG PET/CT发现阴囊Paget病伴体内多发转移一例[J]. 中华核医学与分子影像杂志，2012，32（4）：309-310. [13]Kanitakis J. Mammary and extramammary Paget’s disease[J]. J Eur Acad Dermatol Venereol, 2007, 21(5): 581-590. [14]Dai B, Kong YY, Chang K, et al. Primary invasive carcinoma associated with penoscrotal extramammary Paget’s disease: A clinicopathological analysis of 56 cases[J]. BJU Int, 2015, 115(1): 153-160. [15]Hartman R, Chu J, Patel R, et al. Extramammary Paget disease[J]. Dermatol Online J, 2011, 17(10): 4. [16]李宁宁，白春梅，贾宁，等. 转移性阴囊Paget病3例报道及文献综述[J]. 癌症进展，2012，10（6）：594-600. [17]Cho SB, Yun M, Lee MG, et al. Variable patterns of positron emission tomography in the assessment of patients with extramammary Paget’s disease[J]. J Am Acad Dermatol, 2005, 52(2): 353-355. [18]Aoyagi S, Sato-Matsumura KC, Shimizu H. Staging and assessment of lymphnode involvement by 18F-fluorodeoxyglucose-positron emission tomography in invasive extramammary Paget’s disease[J]. Dermatol Surg, 2005, 31(5): 595-598. [19]丁重阳，高珂梦，李天女，等. 阴囊Paget病18F-FDG PET-CT显像三例并文献复习[J]. 肿瘤研究与临床，2017，9（12）：844-846. [20]Mochitomi Y, Sakamoto R, Gushi A, et al. Extramammary Paget’s disease/carcinoma successfully treated with a combination chemotherapy: Report of two cases[J]. J Dermatol, 2005, 32(8): 632-637. [21]Tsuji M, Nakai N, Ueda E, et al. Double cancer of plantar malignant melanoma and vulvar extramammary Paget’s disease[J]. J Dermatol, 2010, 37(5): 484-487.