病理Ⅰ期肺腺癌^18F-脱氧葡萄糖的摄取特点及其对预后的影响  

Correlation analysis between ^18F-FDG uptake features and the prognosis in patients with pathologic stage Ⅰ lung adenocarcinoma

作　　者：刘瑛[1] 吴宁[1] 毕高畅 张东晟[1] 郑容[1] 梁颖[1] 张雯杰[1] 李小萌[1] 方艳[1] 

机构地区：[1]国家癌症中心中国医学科学院北京协和医学院肿瘤医院PET-CT中心,100021

出　　处：《中华肿瘤杂志》2016年第4期263-269,共7页Chinese Journal of Oncology

基　　金：北京市科技计划（D141100000214006）;国家高技术研究发展（863）计划（2014AA020602）;国家重大科学仪器设备开发专项（2011YQ17006710）

摘　　要：目的：分析Ⅰ期肺腺癌^18F-脱氧葡萄糖（^18F-FDG）的摄取特点以及病灶的摄取对患者预后的预测价值。方法回顾性分析117例病理Ⅰ期肺腺癌患者的^18F-FDG正电子发射计算机断层扫描表现，比较不同临床病理特征患者的最大标准摄取值（ SUVmax）。采用Spearman相关性分析分析病变的摄取与患者临床病理特征的关系，采用受试者工作特征曲线预测肿瘤复发或转移的SUVmax临界值，采用Kaplan-Meier法和Log rank检验分析不同临床病理特征患者的无进展生存情况。结果不同性别、肿瘤大小、肿瘤密度、肿瘤分化程度和T分期的Ⅰ期肺腺癌的SUVmax差异均有统计学意义（均P＜0．05），肿瘤越大、实性成分越多、分化程度越低，其SUVmax越高；T1b期肺腺癌的SUVmax明显高于T1a和T2a期；男性组的SUVmax高于女性组。Ⅰ期肺腺癌的SUVmax与肿瘤大小呈正相关（P＜0．01），与肿瘤密度和分化程度均呈负相关（均P＜0．01），与T分期无关（P＞0．05）。SUVmax＜3．0组和SUVmax≥3．0组患者的无进展生存时间（PFS）分别为（75．1±3．0）个月和（52．7±5．9）个月，差异有统计学意义（P＜0．01）。高分化腺癌和低分化腺癌患者的PFS分别为（76．7±4．2）个月和（45．7±5．4）个月，差异有统计学意义（P＜0．05）。患者的性别、年龄、吸烟史、肿瘤大小、肿瘤密度和T分期与肿瘤进展均无关（均P＞0．05）。结论Ⅰ期肺腺癌的18 F-FDG摄取与肿瘤大小、肿瘤密度和分化程度相关，且对预后有较高的预测价值。 SUVmax＜3．0组的PFS优于SUVmax≥3．0组。Objective To analyze the ^18F-FDG uptake features and the correlation between ^18F-FDG uptake and the prognosis in patients with pathologic stageⅠlung adenocarcinoma. Methods One hundred and seventeen patients with stageⅠlung adenocarcinoma proved by surgery, who underwent a preoperative ^18F-FDG PET-CT, were studied retrospectively. The tumors′ SUVmax in different groups of clinicopathologic factors were compared. The correlations between the SUVmax and clinicopathologic factors were analyzed using Spearman rank correlation. The ROC was plotted to estimate the most discriminative cut-off point for SUVmax in predicting the recurrence or progression of tumor. The progression-free survival （ PFS） in different clinicopathologic groups were estimated using the Kaplan-Meier method and Log-rank test. Results The SUVmax of pathologic stageⅠlung adenocarcinomas were significantly different in different groups of gender,tumor size, density, tumor differentiation grade and T staging, respectively （ P〈0.05 for all） . Patients with a larger tumor size, a higher proportion of solid component, poorer grade of tumor differentiation had a higher SUVmax. The T1b group had a higher SUVmax than T1a and T2a groups. The male group had a higher SUVmax than the female group. The SUVmax was positively correlated with the size＆amp;nbsp;of the adenocarcinomas （ P〈0. 01 ） , and was negatively correlated with both the density and tumor differentiation grade （P〈0.01）. But there was no correlation between SUVmax and the T stage （P〉0.05）. The patients with an SUVmax of〈3.0 had a much better PFS （75.1±3.0 month）than those with an SUVmax of ≥3.0 （52.7±5.9 month）（P〈0.01）. The tumor with a poorer differentiation grade was associated with reduced PFS （45.7±5.4 months） compared with those with well differentiated tumor （76.7±4.2 month）（P〈0.05） . The PFS showed no statistically significant differences in different gender, age, smoking history, tumor size, density and T staging

关 键 词：肺肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 氟脱氧葡萄糖F18 标准化摄取值 预后 

分 类 号：R734.2[医药卫生—肿瘤]