FDG PET-CT标准摄取值用于非小细胞肺癌复发的预测价值  

The prognostic significance of FDG PET-CT standardized uptake value in patients with non-small cell lung cancer

作　　者：徐晓庆[1] 孙新东[1] 杨国仁[2] 付正[2] 于金明[1] 胡漫[1] 

机构地区：[1]山东省肿瘤医院放疗科,山东济南250117 [2]山东省肿瘤医院PET/CT,山东济南250117

出　　处：《中华放射肿瘤学杂志》2008年第2期97-100,共4页Chinese Journal of Radiation Oncology

摘　　要：目的探讨非小细胞肺癌（NSCLC）患者治疗前后FDG PET-CT的标准摄取值（SUV）及其变化在预测复发和转移中的作用。方法48例Ⅲ期NSCLC患者治疗前后均行全身PET-CT检查，并计算出肺部肿瘤病灶感兴趣区的最高标准摄取值（SUVmax），治疗前后SUVmax的变化用ASUV来衡量。结果最后入组45例，中位随访22．5个月，24例出现局部或区域复发、转移，21例无复发、转移。出现局部或区域复发、转移组治疗前和后SUVmax分别为12.30±3.17和5.35±2.29，无复发、转移组治疗前和后的分别为8.46±3.00和2.82±0.63，前者的SUVmax均高于后者（t前=4.15，P前〈0．01；t后=4.88，P后〈0．01）。治疗前后SUVmax变化百分率两组间差异无统计学意义（t=1．99，P〉0．05）。治疗前SUVmax=9.0时，对复发和转移预测的敏感性、特异性、阳性预测值、阴性预测值分别为92％、62％、73％、87％；治疗后SUVmax=4.3时，对复发和转移的分别为71％、100％、100％、72％。结论治疗前后SUVmax高者近期出现复发和转移的可能性较大，可较早预测NSCLC复发的高危人群。NSCLC患者治疗前后SUV值可能是与生存相关的重要预后因素。Objective To determine the prognostic value of standardized uptake value （SUV） of fluorodeoxyglucose（FDG） by positron emission tomography and computed tomography （PET-CT） in nonsmall cell lung cancer （NSCLC）. Methods Forty-eight patients （39 male, 9 female） with stage Ⅲ NSCLC were reviewed. All patients had at least two repeated FDG PET-CT scans either before and after therapy and the maximum standardized uptake value（ SUVmax）of the primary lung lesion was calculated. Resuits Of the 45 eligible patients, after a median follow-up of 22.5 months （ rang, 13 to 35 months）, 24 patients had local and regional recurrence or metastasis and 21 remain disease-flee. The mean SUVmax of patients who had local recurrence or metastasis before and after treatment was 12.30±3.17 and 5.35±2.29, respectively. The mean SUVmax of patients who had no local recurrence or metastasis before and after treat-ment was 8.46±3.00 and 2.82 ±0.63, respectively. Significant differences （ tbefore= 4.15, Pbefore〈 0.01 ; Pafter=4.88 ,Pafter〈 0.01 ） in SUVmax were observed either before and after treatment. However, the percent change of SUVmax between pretreatment and post-treatment were not significiantly different （ t = 1.99, P 〉 0.05 ）. Using the SUVbefore of 9.0 yielded 92% sensitivity, 62% specificity, 73% positive predictive value and 87% negative predictive value in predicting regional recurrence or metastasis. While using the SUVafter of 4.3 yielded 71% sensitivity, 100% specificity, 100% positive predictive value and 72% negative predictive value. Conclusions PET-CT may have the potientials to predict response to therapy and the SUVmax is a significant predictor for recurrent or metastasis in patients of NSCLC.

关 键 词：肺肿瘤 体层摄影术 正电子发射型 标准摄取值 预后 

分 类 号：R686[医药卫生—骨科学]