鼻咽癌^(18)F-脱氧葡萄糖PET代谢活性容积与预后关系的初步研究  

Correlation between ^(18)FDG PET metabolic activity volume and prognosis in nasopharyngeal carcinoma

作　　者：李新科[1] 于金明[1] 付政[2] 孙新东[1] 黄勇[3] 袁双虎[1] 孟雪[1] 

机构地区：[1]山东省肿瘤医院放疗科,山东济南250117 [2]山东省肿瘤医院核医学科,山东济南250117 [3]山东省肿瘤医院CT室,山东济南250117

出　　处：《中华肿瘤防治杂志》2009年第6期443-446,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:初步探讨鼻咽癌18FDGPET代谢活性容积与预后的关系。方法:回顾性分析经病理确诊、有完整随访资料的鼻咽癌初治患者39例,所有患者均有治疗前18FDGPET-CT资料。在PET图像上以标准化摄取值(SUV)=2.5扣本底确定原发灶及阳性淋巴结的边界,计算其代谢活性容积(MAV),所有患者均行根治性调强放疗或同期放化疗。结果:T1、T2、T3和T4期的平均原发灶MAV(MAV-P)分别为(6.86±5.67)、(20.45±16.11)、(34.09±22.35)和(55.38±32.79)cm3,差异有统计学意义,P=0.001。原发灶最高标准化摄取值(SUV-P)为8.33±3.84,各T分期之间差异有统计学意义,P=0.003;MAV-P与SUV-P显著相关,r=0.782,P<0.001。3年局部区域控制率为90.7%(34/39),3年无远地转移生存率为84.7%(31/39),3年无进展生存率为80.5%(28/39)。单因素分析显示,总肿瘤MAV(TMAV)>60cm3、转移淋巴结MAV(MAV-Ln)>30cm3及SUV-P>9.5者3年无远地转移生存率及无进展生存率均显著降低,P<0.05。结论:应用18FDGPET检查获得鼻咽癌MAV是可行的,鼻咽癌TMAV、MAV-Ln和SUV-P均是影响疾病进展及远地转移的预后因素。OBJECTIVE：To explore the relationship between the tumor prognosis and tumor metabolic activity volume measured by ^18FDG PET-CT in patients with nasopharyngeal carcinoma. METHODS： Thirth-nine patients who were treated for the first time were analyzed, all the patients were histopathologically confirmed, and had 18FDG PET-CT scan before the treatment and detailed follow-up data. The boundary of primary tumor and positive lymph node were defined with a absolute SUV of 2.5 as segmentation threshold on PET image, and on the basis of this boundary MAV was calculated. All the patients were treated by radical IMRT or concurrent chemoradiotherapy. RESULTS：The mean MAVs in T1,T2,T3, T4 groups were （6.86±5.67）, （20.45±16.11）, （34.09±22.35） and （55.38±32.79） cm^3 respectively. The difference between each T group was significant （P=0.001）. The mean maximum SUV of primary tumor was 8.33±3.84, and the difference between each T group was also significant （P=0.003）. There was a significant correlation between MAV and maximum SUV of primary tumor （P〈0.001）. The 3-year local control rate, metastasis-free survival rate and progression-free survival rate were 90.7%（34/39）,84.7%（31/39） and 80.5%（28/39）, respectively. Univariate analysis showed that the disease progression rate and distant metastasis rate were significantly higher in the total MAV〉60 cm^3, positive lymph node MAV〉30 cm^3 group or primary lesion maximum SUV〉9.5 group （P〈0.05）. CONCLUSIONS：It is feasible to acquire tumor metabolic activity by ^18FDG PET scan in patients with nasopharyngeal carcinoma. Total MAV, lymph node MAV and maximum SUV of primary lesion are all prognostic factors that affect tumor metastasis and progression.

关 键 词：鼻咽肿瘤/放射疗法 正电子发射断层显像术 预后 回顾性研究 

分 类 号：R739.63[医药卫生—肿瘤]