Nuclear Medicine and Molecular Imaging

  • 제43권1호
  • /
  • Pages.40-47
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  • 2009
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  • 1869-3474(pISSN)
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  • 1869-3482(eISSN)
대한핵의학회 (The Korean Society of Nuclear Medicine)
권호 표지

분화성 갑상선 암에서 FDG 섭취 정도와 병리학적 지표들과의 비교

Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer

  • 최우희 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 정용안 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 김기준 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 박창숙 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 정현석 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 손형선 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 정수교 (가톨릭대학교 의과대학 방사선과학교실) ;
  • 유창영 (가톨릭대학교 의과대학 병원병리학교실)
  • Choi, Woo-Hee (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Chung, Yong-An (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Ki-Jun (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Park, Chang-Suk (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Jung, Hyun-Suk (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Sohn, Hyung-Sun (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Chung, Soo-Kyo (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Yoo, Chang-Young (Department of Hospital Pathology, College of Medicine, The Catholic University of Korea)
  • 발행 : 2009.02.28
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초록

목적: 분화성 갑상선 암에서 원발 종양의 F-18 FDG 섭취 정도와 여러 병리학적, 면역조직화학적 지표들과의 연관성을 알아보고자 하였다. 대상 및 방법: 본원에 내원하여 수술 전 F-18 FDG PET/CT 스캔을 시행한 후 갑상선 전 절제술 및 림프절 제거술을 시행한 분화성 갑상선암 환자들을 대상으로 하였다. PET/CT 영상에서 원발성 종양의 SUVmax를 구한 후 SUVmax와 종양의 크기, 림프절 전이, 종양의 다발성, 갑상선 밖으로의 침습, 갑상선염 동반 여부와 같은 병리학적 인자들과 Ki-67 표지을, EGFR, COX-2, 그리고 Galectin-3 같은 면역조직화학적 지표들과 관계가 있는지를 독립표본 T 검정을 사용하여 알아보았다. 결과: 106명의 환자 중 102명은 유두상암이었고 4명은 여포상암이었다. 1 cm보다 큰 종양에서의 평균 SUVmax는 1 cm이하 종양에서의 평균 SUVmax보다 의미 있게 높았다($7.8{\pm}8.5$ vs. $3.6{\pm}3.1$, p=0.004). 그 외 림프절 전이, 종양의 다발성, 갑상선 밖으로의 침습, 갑상선염 동반 유무, Ki-67 표지율, EGFR, COX-2, Galectin-3 발현 유무에 따라 분화성 갑상선 암의 SUVmax는 통계학적으로 유의한 차이가 없었다. 결론: 분화성 갑상선 암에서 F-18 FDG의 섭취 정도는 원발성 종양의 크기와 통계적으로 유의한 연관성이 있었다. 그러나 Ki-67 표지율, EGFR, COX-2, Galectin-3 발현 유무와 F-18 FDG섭취 정도는 유의한 관련성이 없었다.

Purpose: Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. Materials and Methods: DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of a portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. Results: Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones ($7.8{\pm}8.5$ vs. $3.6{\pm}3.1$, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX- 2 and Galectin-3. Conclusion: In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.

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