南方医科大学学报

南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (11): 1650-.

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18F-FDG PET-CT对有气管粘膜病变的肺结节病的评价作用

张春阳，冯华松，张燕，雷霄，梁英奎，丁新民，孟激光，韩志海   

  • 出版日期:2014-11-20 发布日期:2014-11-20

Evaluation of bronchial mucosa involvement in sarcoidosis patients using 18F-FDG PET-CT

  • Online:2014-11-20 Published:2014-11-20

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摘要： 目的了解18F-FDG PET-CT检查对气管粘膜受累的结节病活动性的评价作用。方法回顾分析结节病气管粘膜受累的患
者6例和粘膜未受累的患者14例的临床资料，对18F-FDG PET-CT检查肺部病灶、肺门、纵隔淋巴结的标准摄取率（SUV）最大
值、平均值和血清血管紧张素转换酶、肺泡灌洗液（BALF）中CD4+与CD8+比值、淋巴细胞比例进行对比分析。结果气管腔内有
粘膜改变组肺部病灶的SUV最大值/SUV平均值均高于粘膜无改变组（7.04±5.83/5.00±4.69 vs 5.68±3.66/3.82±2.39），但无统计
学差异（P=0.565/0.495）；气管腔内有粘膜改变组肺门、纵隔淋巴结的SUV最大值/SUV平均值均明显高于粘膜无改变组（13.28±
5.57/10.48±4.43 vs 6.20±1.77/4.52±1.43；13.84±4.35/9.69±2.74 vs 7.16±2.52/5.28±1.77），有统计学差异（P=0.0003/0.0002；P=
0.0004/0.0004）。气管腔内有粘膜改变组血清血管紧张素转换酶水平和BALF 中CD4+/CD8+比例分别高于粘膜无改变组
（60.58±16.3 IU/L vs 49.16±13.3 IU/L；7.30±5.0 vs 2.90±3.1），两者比较均有统计学意义（P=0.045；0.026）。BALF中检测淋巴细
胞比例，粘膜改变组虽高于粘膜无改变组［（44.10±10.3）% vs（35.30±12.5%）］，但无统计学意义（P=0.148）。结论气管粘膜受
累是活动性结节病的表现之一，18F-FDG PET-CT检查为评价支气管粘膜受累结节病的活动性提供了一定的帮助。

Abstract: Objective To explore the value of 18F-FDG PET-CT in evaluating bronchial mucosa involvement in patients with
saroidosis. Methods A retrospective analysis was conducted among 6 sarcoidosis patients with and 14 patients without
bronchial mucosa involvement to collect the data including the standard uptake value (SUVMax/Mean) of 18F-FDG, serum
angiotensin converting enzyme (sACE), and proportion of lymphocytes and CD4+/CD8 + T lymphocyte ratio in bronchoalveolar
lavage fluid (BALF). Results The lung focal SUV (Max/Mean) was higher in patients with bronchial mucosa involvement than those
without (7.04±5.83/5.00±4.69 vs 5.68±3.66/3.82±2.39), but such differences were not statistically significant (P=0.565/0.495). The
SUV(Max/Mean) of the hilum of the lung and the mediastina lymph nodes were significantly higher in patients with bronchial
mucosa involvement (13.28±5.57/10.48±4.43 vs 6.20±1.77/4.52±1.43, P=0.0003/0.0002; 13.84±4.35/9.69±2.74 vs 7.16±2.52/5.28±1.77,
P=0.0004/0.0004). The level of sACE and CD4 +/CD8 + T lymphocyte ratio in BALF were also significantly higher in patients
with bronchial mucosa involvement (60.58±16.3 vs 49.16±13.3 IU/L, P=0.045; 7.30±5.0 vs 2.90±3.1, P=0.026). The proportion of
lymphocytes in BALF was comparable between the patients with and without bronchial mucosa involvement (44.10±10.3% vs
35.30 ± 12.5%, P=0.148). Conclusions For patients with saroidosis, 18F-FDG PET-CT is useful in evaluating bronchial mucosa
involvement, which is one of the key features of active sarcoidosis.