^18F-FDG PET／CT显像评价中晚期胃癌治疗效果和预后的临床研究  

Prognostic evaluation and therapeutic effect assessed by ^18F-FDG PET/CT for advanced gastric cancer

作　　者：叶丽霖 杨航 张清波[2] 杨静 尹预真 朱蔚友 庞丽俊 周虹 闵艳艳 李丹明 Ye Lilin;Yang Hang;Zhang Qingbo;et al(Department of Oncology,Jiangsu Shengze Hospital Affiliated to Nanjing Medical University, Wujiang 215228, China)

机构地区：[1]南京医科大学附属江苏盛泽医院肿瘤科,江苏吴江215228 [2]南京医科大学第一附属医院核医学科 [3]南京医科大学第一附属医院放射治疗科

出　　处：《临床内科杂志》2018年第4期237-240,共4页Journal of Clinical Internal Medicine

基　　金：苏州市“科教兴卫”青年科技项目（kjxw2014054）

摘　　要：目的探讨正电子核素^18F标记的氟脱氧葡萄糖正电子发射断层扫描（^18F-FDGPET／CT）对中晚期胃癌患者疗效和预后的临床评估价值。方法将35例中晚期胃癌患者根据病史分为单纯化疗（CT）组23例和同步放化疗（CCRT）组12例，分别于治疗前、治疗第3～4周和治疗后1—3个月行^18F—FDGPET／CT检查，比较其最大标准摄取值（SUVmax）和代谢肿瘤体积（MTV）与治疗前的变化百分比（△SUVmax％和AMTV％）。在CCRT组和CT组中，以ASUVmax％降低≥43．08％作为闽值将每组分为两个亚组，采用受试者工作特征（ROC）曲线评价代谢参数的敏感性和特异性，分析总生存期（OS）和无进展生存期（PFS）的影响因素。结果胃腺癌原发病灶的平均SUVmax随着治疗时间的延长逐渐降低。CT组和CCRT组的总缓解率（34．8％比50．0％，P=0．383）、疾病控制率（73．9％比75．0％，P=0．944）比较，差异无统计学意义；两组OS和PFS比较差异均无统计学意义（P〉0．05）。CT组治疗后SUV-及MTV越低，则OS、PFS越长（P〈0．05），而CCRT组包括SUVmax变化率在内的所有临床因素与OS、PFS无相关性（P〉0．05）。结论行CT和CCRT治疗的△SUVmax％降低≥43．08％的中晚期胃癌患者OS和FPS均较长，提示预后更佳。^18F-FDG PET／CT对评估中晚期胃癌治疗效果及预后具有应用价值。Objective To investigate theprognostic evaluation and therapeutic effect assessed by ^18 F-FDG PET/CT for advanced gastric cancer. Methods A total of 35 patients with advanced gastric cancer were divided into two groups, 23 patients in chemotherapy （CT） group and 12 patients in concurrent chemoradiation therapy（CCRT） group according to case history. ^18F-FDG PET/CT images for each patient were acquired at pre-treatment, during-treatment at 3-4 weeks, and 1-3 months posttreatment. The percentage changes in the maximum values of standardized uptake value （ ASUVm= % ） and metabolic tumour volume（ AMTV% ） from the PET/CT images were compared. Each group was classified as two sub-group by a decrease of ≥43.08% of △SUVmax% between pre-treatment and post-treatment PET/CT. Receiver operating characteristic （ROC） curve analysis was performed to evaluate the specificity and sensitivity of each metabolic parameter. Affecting factors of progression-free survival（PFS） and overall survival（ OS ） were analyzed. Results Mean SUVmax, for primary tumor of gastric adenocarcinoma decreased gradually with the prolongation of treatment time. No significant difference between CT group and CCRT group were observed for overall response rate（ ORR,34. 8% vs 50.0% ,P = 0. 383 ） and disease control rate（ DCR,73.9% vs 75.0% ,P = 0. 944）. There was no significant difference in OS and PFS between two groups （P 〉 0. 05 ）. For CT group, when the SUVmax and MTV were lower after treatment, OS and PFS were longer,while all clinical factors including SUVmax change rate were not correlated with OS and PFS in CCRT group（P 〉 0.05）. Conclusion OS and FPS in patients with advanced gastric cancer and a decrease of ASUVmax% ≥43.08% who receive CT and CCRT are longer which suggests that the prognosis is better, ^18F-FDG PET/CT is of great significance to evaluating the therapeutic effect and prognosis of advanced gastric cancer.

关 键 词：胃癌 ^18F-脱氧葡萄糖正电子发射断层扫描 同步放化疗 

分 类 号：R739.41[医药卫生—肿瘤]