[摘要] 目的: 探究食管鳞癌胃壁内转移（IGM）患者正电子发射计算机体层显像仪（PET/CT）代谢参数与病理特征及预后的关系。方法: 收集安徽医科大学附属省立医院2008 年1 月至2014 年12 月收治的食管鳞癌IGM患者86 例，外科手术前采用PET/CT 对患者进行影像学检查，检测患者IGM 最大标准摄取值（SUVmax）、代谢体积（MTV）、PET 长度（PTL）和平均标准摄取值（SUVmean），计算得出病灶糖酵解总量（TLG）等代谢参数。记录患者5 年随访期间生存情况，分析代谢参数与患者临床病理特征及预后的关系。结果: 食管鳞癌IGM SUVmax 和SUVmean 与肿瘤原发灶肉眼直径有关（均P<0.05）；MTV与原发灶肉眼直径、淋巴结转移情况和TNM分期有关（均P<0.05）；TLG与原发灶肉眼直径、淋巴结转移情况、TNM分期和组织分化程度有关（均P<0.05）。5 年随访期间，共有6 例患者失访，36 例患者死亡，44 例患者5 年随访结束仍存活；SUVmax、MTV、TLG、PTL、SUVmean和TNM分期是患者预后的预测因子（均P<0.05）；MTV、TLG、PTL、SUVmean、TNM分期是患者预后的危险因素（均P<0.05）。结论: 食管鳞癌IGM 患者PET/CT 检查中的SUVmax、MTV、TLG、PTL、SUVmean 等代谢参数与患者病理特征有关，MTV、TLG、PTL、SUVmean、TNM分期是患者预后的危险因素，食管鳞癌IGM患者行PET/CT检查对患者预后评估有一定价值。

[Abstract] Objective: To investigate the relationship between PET/CT metabolic parameters and pathological features and prognosis in esophageal squamous cell carcinoma (ESCC) patients with intramural gastric metastasis (IGM). Methods: Totally 86 cases of ESCC IGM patients treated in Anhui Provincial Hospital Affiliated to Anhui Medical University from January 2008 to December 2014 were selected for this study. The patients received the imaging examination by positron emission tomography and computed tomography (PET/CT). The metabolic parameters including maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), PET tumor length (PTL) and mean standard uptake value (SUVmean) were examined to calculate the total lesion glycolysis (TLG). The survival of the patients during 5-year follow-up was recorded, and the relationship between metabolic parameters and clinical pathological features and prognosis was analyzed. Results: SUVmax and SUVmean of IGM patients were related to the diameter of the primary tumor (all P<0.05); MTV was associated with the tumor diameter, lymph node metastasis, and TNM staging (all P<0.05); TLG was associated with the tumor diameter, lymph node metastasis, TNM stage, and tissue differentiation (all P<0.05). During the 5-year follow-up, 6 patients were lost to follow-up, 36 patients died and 44 patients survived; SUVmax, MTV, TLG, PTL, SUVmean, and TNM staging were predictors for patients’prognosis (all P<0.05); MTV, TLG, PTL, SUVmean, and TNM staging were risk factors for prognosis (all P<0.05). Conclusion: The metabolic parameters including SUVmax, MTV, TLG, PTL and SUVmean in ESCC patients with IGM are related to the pathological characteristics of patients; moreover, MTV, TLG, PTL, SUVmean and TNM staging are risk factors for prognosis;so, PET/CT examination has certain clinical value for the prognosis assessment in ESCC patients with IGM.

吴阶平医学基金会临床科研专项基金资助（No. 32027301899）