PET/CT纵隔淋巴结SUVmax与N_0～N_1期非小细胞肺癌手术患者预后相关性的研究  

Prognostic value of mediastinal lymph node SUVmax for patients with postoperative N_0 ～N_1 stage non-small cell lung cancer

作　　者：张利卜[1] 徐文贵[1] 汪莹[2] 戴东[1] 马文超[1] 朱研佳[1] 门晓媛[1] 

机构地区：[1]天津医科大学附属肿瘤医院分子影像与核医学诊疗科,天津市肿瘤防治重点实验室,天津市300060 [2]天津市卫生监督所

出　　处：《中国肿瘤临床》2013年第6期358-362,共5页Chinese Journal of Clinical Oncology

基　　金：天津市自然科学基金重点项目(编号:08JCZDJC23700);天津市教委课题项目(编号:20080133)资助~~

摘　　要：目的:评价NSCLC患者行根治性切除术后,纵隔淋巴结组织学检查阴性(N0～N1期)的患者术前纵隔淋巴结FDG摄取水平对患者预后的意义。方法:回顾性总结了2005年4月至2009年5月在天津医科大学附属肿瘤医院行PET/CT检查后接受手术治疗的N0～N1期NSCLC患者的PET/CT数据、术后随访资料及临床资料。运用Kaplan-Meier法及Log-rank检验对纵隔淋巴结SUVmax以及性别、年龄、组织学类型、TNM分期、术后辅助治疗、原发病灶SUVmax等分别与患者生存时间进行单因素生存分析,采用Cox回归风险比例模型对影响预后的各因素进行多因素生存分析。结果:单因素分析表明,术前PET/CT纵隔淋巴结SUVma(xP=0.001)以及TNM分期(P<0.001)、原发病灶SUVma(xP=0.001)、是否有术后辅助治疗(P=0.012)对N0～N1期NSCLC患者术后预后存在预测作用;多因素分析表明,只有TNM分期(P=0.017)、原发病灶SUVma(xP=0.027)及纵隔淋巴结SUVma(xP=0.046)是影响本组NSCLC患者术后生存的独立预后因素,三者的相对危险度分别为2.230,2.179及1.962。结论:对于N0～N1期的NSCLC术后患者,术前PET/CT纵隔淋巴结SUVmax、TNM分期、原发病灶SUVmax均是影响患者术后生存的因素。将三者结合起来,对于指导临床尽早制定术后个体化治疗方案、延长患者生存期具有重要意义。Objective： This study assesses the prognostic significance of the uptake level of mediastinal lymph nodes of fluo- ro-2-deoxy-D-glucose in patients undergoing curative resection of non-small cell lung cancer （NSCLC） who have histologically nega- tive mediastinal lymph nodes （N0-N, stage）. Methods： Preoperative positron emission tomography/computerized tomography （PET/CT） data and clinical follow-up materials of patients who underwent curative surgery with pathologic No-NL stage of NSCLC at the Tianjin Medical University Cancer Hospital from April 2005 to May 2009 were reviewed, Maximum standardized uptake value （SUV） ofme- diastinal lymph nodes and primary tumor, as well as gender, age, histologic type, tumor-node-metastasis （TNM） stage, and postopera- tive adjuvant therapy, were compared to determine their association with patient survival. Kaplan-Meier method and log-rank test were used in the univariate analysis and Cox proportional hazard regression model was used in the multivariate analysis. Results： For the N0-N NSCLC patients, univariate analysis showed that SUV, of mediastinal lymph nodes （P= 0.001）, TNM staging （P〈0.001）, SUV- max of primary tumor （P=0.001）, and postoperative adjuvant therapy （P=0.012） were significant predictors of survival. Multivariate anal- ysis showed that TNM staging （P=0.017） and SUVm of primary tumor （P=0.027） and mediastinal lymph nodes （P=0.046） were inde- pendent predictors of survival with relative risks of 2.230, 2.179, and 1.962, respectively. Conclusion： According to the SUVm, of medi- astinal lymph nodes in the preoperative PET/CT imaging and TNM staging, SUV,x of primary tumor is the predictor for N0-N NSCLC patient survival. These results have important implications for guiding individual treatment after surgery and for prolonging patient sur- vival.

关 键 词：非小细胞肺癌PET CT纵隔淋巴结标准摄取值预后 

分 类 号：R734.2[医药卫生—肿瘤]