基于动态18F-FDG PET/CT探讨乳腺癌肝郁痰凝证与冲任失调证患者腋窝淋巴结代谢差异OA
Metabolic Differences in Axillary Lymph Nodes Between Breast Cancer Patients with Liver Depression and Phlegm Stagnation Syndrome and Chong-Ren Disharmony Syndrome Based on Dynamic 18F-FDG PET/CT
目的 探讨肝郁痰凝证与冲任失调证乳腺癌患者腋窝淋巴结 18F-FDG代谢动力学的差异及其临床意义.方法 前瞻性纳入27例辨证为肝郁痰凝证或冲任失调证的乳腺癌患者,行PET/CT动态显像(注射后连续采集60 min,并于90、120、150 min行静态扫描).勾画91枚腋窝淋巴结感兴趣区,获取各时间点最大标准化摄取值和平均标准化摄取值,比较两组代谢参数差异.结果 冲任失调证组患者年龄显著高于肝郁痰凝证组[(59.82±8.05)岁 vs(44.38±7.91)岁,P＜0.001].在早期时相(1～10 min),冲任失调证组SUVmax及SUVmean均显著高于肝郁痰凝证组(P＜0.05);自15 min起,两组差异无统计学意义.两组间早期摄取斜率及标准化摄取值差异均无统计学意义.年龄亚组分析显示,在≥50岁患者中,肝郁痰凝证组峰值时间晚于冲任失调证组(P＜0.05).控制年龄因素后,证型间早期代谢差异无统计学意义.结论 本研究初步发现冲任失调证与肝郁痰凝证乳腺癌腋窝淋巴结早期代谢差异主要源于年龄因素,提示中医证型与生理阶段存在深度耦合.
Objective To explore the differences in 18F-FDG metabolic kinetics of axillary lymph nodes in breast cancer patients with liver depression and phlegm stagnation syndrome and those with Chong-Ren disharmony syndrome,and to investigate the clinical significance.Methods A total of 27 patients diagnosed with liver depression and phlegm stagnation syndrome or Chong-Ren disharmony syndrome were prospectively included.Dynamic PET/CT imaging was performed(continuous acquisition for 60 minutes after injection,and static scans at 90,120,and 150 minutes).Regions of interest were delineated for 91 axillary lymph nodes,and the maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)at each time point were obtained.The differences in metabolic parameters between the two groups were compared.Results The age of patients in the Chong-Ren disharmony syndrome group was significantly higher than that in the liver depression and phlegm stagnation syndrome group[(59.82±8.05)years vs(44.38±7.91)years,P＜0.001].In the early time phase(1～10 minutes),SUVmax and SUVmean in the Chong-Ren disharmony syndrome group were significantly higher than those in the liver depression and phlegm stagnation syndrome group(P＜0.05);from 15 minutes onward,no significant differences were observed between the two groups.There were no statistically significant differences in the early uptake slope or standardized uptake values between the two groups.Age subgroup analysis showed that in patients≥50 years old,the peak time in the liver depression and phlegm stagnation syndrome group was later than that in the Chong-Ren disharmony syndrome group(P＜0.05).After controlling for age,the early metabolic differences between the two syndromes were no longer significant.Conclusion This study preliminarily suggests that the early metabolic differences in axillary lymph nodes between the Chong-Ren disharmony syndrome and liver depression and phlegm stagnation syndrome in breast cancer mainly originates from age,indicating a deep coupling between traditional Chinese medicine syndromes and physiological stages.
李圆;冯雅雯;杨少习;谢石文
广州中医药大学第一附属医院/广东省中医临床研究院核医学科,广东 广州 510405广州中医药大学第一附属医院/广东省中医临床研究院核医学科,广东 广州 510405广州中医药大学第一附属医院/广东省中医临床研究院核医学科,广东 广州 510405广州中医药大学第一附属医院/广东省中医临床研究院核医学科,广东 广州 510405
医药卫生
乳腺肿瘤肝郁痰凝证冲任失调证正电子发射断层显像氟脱氧葡萄糖F18年龄因素
breast tumorliver depression and phlegm stagnation syndromeChong-Ren disharmony syndromepositron emission tomographyfluorodeoxyglucose F18age factor
《中医肿瘤学杂志》 2026 (3)
53-59,93,8
广东省中医药局基金(编号:20241108)广东省医学基金(编号:B2023236).
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