^(18)F-FDG PET/CT与常规CT评价非小细胞肺癌早期化疗疗效的对照研究  

A comparative study of ^(18)F-FDG PET/CT and CT in the early evaluation of response to chemotherapy in patients with non-small cell lung cancer

作　　者：邢军[1] 靳宏星[1] 原凌[1] 张红雨 任基伟[2] 田蓉蓉[1] 赵铭[1] 

机构地区：[1]山西省肿瘤医院PET/CT中心,太原市030013 [2]山西省肿瘤医院核磁CT室,太原市030013

出　　处：《中国肿瘤临床》2016年第4期156-160,共5页Chinese Journal of Clinical Oncology

基　　金：山西省自然科学基金项目(编号:20081073-3)资助~~

摘　　要：目的:探讨^(18)F-FDG PET/CT的早期肿瘤代谢疗效与常规CT依据RECIST标准(实体瘤疗效评价标准),评价非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗最佳客观疗效之间的关系。方法:收集2009年9月至2014年12月山西省肿瘤医院经病理学确诊初治不可切除的局部晚期和晚期非小细胞肺癌(NSCLC)患者40例,行含铂双药方案全身化疗。PET/CT按SUV标准(化疗1个周期后肺部原发癌灶的最高SUV值下降>30%)评价肿瘤客观疗效,CT采用RECIST标准评价。配对计数资料采用χ~2检验和κ系数检验,将第1个周期化疗后的代谢缓解率分别与第1周期及第2周期化疗后的最佳客观疗效进行比较,判断两者之间是否具有差异性及一致性。结果:第1个周期化疗后按SUV值评价的代谢缓解率与化疗后RECIST评价标准之间差异具有统计学意义(χ~2=5.063,P<0.05),并且具有较差的一致性(κ=0.240,P=0.085),与2个周期化疗后RECIST评价标准差异无统计学意义(χ~2=2.083,P>0.05),并且具有较好的一致性(κ=0.413,P=0.006);^(18)F-FDG PET/CT预测NSCLC 2个周期化疗后最佳客观疗效的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为82.4%(14/17)、60.9%(14/23)、70.0%(28/40)、60.9%(14/23)和82.4(14/17)%。结论:^(18)F-FDG PET/CT能够预测局部晚期和晚期NSCLC化疗后按RECIST标准评价的最佳客观疗效;^(18)F-FDG PET/CT相对于常规CT可以更早并准确的评价NSCLC的化疗疗效。Objective： The relationship between the effect of early metabolism in ^18F-FDG PET/CT and conventional CT based on the RECIST standard to evaluate the best objective response after chemotherapy in patients with non-small cell lung cancer（NSCLC）. Methods： We studied 40 patients with unresectable locally advanced or advanced NSCLC that were confirmed pathologically. The patients were 35 years old to 78 years old and included 31 males and 9 females. Three patients have unresectable stage ⅢA, 8 patients have stage Ⅲ B, 29 patients have stage Ⅳ, 12 patients have squamous cell carcinoma, and 28 patients have adenocarcinoma. The PET/CT for the effect of chemotherapy was evaluated in NSCLC according to the SUV standard（SUVmax reduction 30% of primary lung cancer after one cycle of chemotherapy）, and the CT for the effect of chemotherapy was evaluated on the basis of NSCLC according to the RECIST standard. The objectives of the study are as follows： compare the differences and consistency between ^18F-FDG PET/CT metabolic response after the first cycle of chemotherapy and the RECIST best objective response after the first or second cycle of chemotherapy with the paired chi-square test and kappa test; calculate the ^18F-FDG PET/CT to predict the best objective response of two cycles of chemotherapy according to RECIST on the basis of NSCLC in terms of sensitivity, specificity, accuracy, positive predictive value, and negative predictive value; compare the differences in SUVmax reduction between the metabolic remission group and metabolic no relief group with the two-sample t-test. All statistical methods were 0.05 for the inspection level, and P〈0.05 was considered statistically significant difference（SPSS19.0）. Results： Differences were found between the first cycle of chemotherapy for the RECIST best objective response and ^18F- FDG PET/CT metabolic response（χ^2=5.063, P=0.021）, and the results had bad consistency（Kappa=0.240, P=0.085）.No differences were observed between the second c

关 键 词：非小细胞肺癌 ^18F-氟脱氧葡萄糖 正电子发射断层显像 化疗 

分 类 号：R734.2[医药卫生—肿瘤]