肿瘤代谢体积对大肠癌患者预后的影响  

Effect of metabolic tumor volume on the prognosis of patients with colorectal cancer

作　　者：本巴吉[1] 祁玉娟[1] 袁青玲 宋晓燕[1] 姬瑞[2] 

机构地区：[1]青海省人民医院肿瘤内科,西宁810007 [2]兰州大学第一附属医院消化科,兰州730000

出　　处：《重庆医学》2016年第30期4246-4248,共3页Chongqing medicine

摘　　要：目的探讨肿瘤代谢体积(MTV)对大肠癌患者血管生成与血行转移的预测价值。方法选取2011年1月至2015年12月青海省人民医院收治的108例大肠癌患者为研究对象,根据患者是否发生血行转移分为转移组(n=42)与非转移组(n=66)。所有患者术前行18氟-氟代脱氧葡萄糖正电子发射计算机断层扫描(18F-FDG PET/CT)扫描,采用PET VERA软件以最大标准摄取值(SUVmax)的40%为临界值自动计算出MTV,并对所有组织标本进行CD34+免疫组织化学标记血管来测量微血管密度(MVD)。比较两组的临床病理资料、SUVmax、MTV及MVD。采用受试者工作特征曲线的曲线下面积(AUC)评价MTV对血行转移的预测价值。结果转移组的SUVmax、MTV与MVD均明显高于非转移组,差异有统计学意义(P<0.05)。不同T分期的MTV与MVD比较,差异有统计学意义(P<0.05)。Pearson相关分析结果表明MTV与MVD呈明显正相关(r=0.636,P<0.001),而MTV与SUVmax无明显相关性(r=0.161,P=0.096),MVD与SUVmax无明显相关性(r=0.179,P=0.064)。MTV预测血行转移的AUC为0.736,最佳阈值为15.016cm3,此时灵敏度、特异度、阳性预测值、阴性预测值及Youden指数分别为83.3%、63.6%、59.3%、85.7%、47.0%。结论与SUVmax相比,大肠癌的MTV与血管形成、血行转移有关,从而较好地预测其预后,值得临床推广应用。Objective To investigate the predictive value of metabolic tumor volume（MTV）in angiogenesis and hematogenous metastasis of patients with colorectal cancer.Methods Totally 108 patients with colorectal cancer from January 2011 to December 2015 were enrolled into the study and divided into metastasis group（n=42）and non-metastasis group（n=66）according to whether combining with hematogenous metastasis.All patients received 18F-2-fluoro-D-glucose positron emission tomography/computed tomography（18F-FDG PET/CT）before operation,then used the PET VERA software to automatically calculate MTV according to the 40% of standard uptake value max（SUVmax）as the threshold.The blood vessels were identified with CD34＋immunohistochemical staining,then measured the microvessel density（MVD）.The clinical pathologic data,SUVmax,MTV and MVD were compared between metastasis group and non-metastasis group.The area under the receiver-operating characteristic curve（AUC）was performed to evaluate the predictive value of MTV on hematogenous metastasis.Results SUVmax,MTV and MVD in metastasis group were significantly higher than that in non-metastasis group（P〈0.05）.There were significant differences in MTV and MVD among patients with different T stage（P〈0.05）.Pearson correlation analysis results showed that MTV was positively correlated with MVD（r=0.636,P0.001）,and there was no significant relationship between MTV and SUVmax（r= 0.161,P=0.0960.05）,MVD and SUVmax（r=0.179,P=0.0640.05）.AUC of MTV was 0.736,and the best threshold value was 15.016cm3,whose sensitivity,specificity,positive predictive value,negative predictive value and Youden index were 83.3%,63.6%,59.3%,85.7% and 47.0% respectively.Conclusion Compared with SUVmax,MTV of colorectal cancer is associated with angiogenesis and hematogenous metastasis,so as to predict the prognosis of colorectal cancer,which is worthy of clinical application.

关 键 词：代谢体积 血行转移 结直肠肿瘤 正电子发射计算机断层扫描 

分 类 号：R735.34[医药卫生—肿瘤]