^(18)F-FDG PET/CT中体积代谢参数对局部晚期宫颈癌根治性放化疗预后影响的探讨  

Prognostic impact of volume metabolic parameters in PET/CT ^(18)F-FDG on the prognosis of locally advanced cervical radical radiotherapy

作　　者：何清[1] 李静[2] 宋红林[1] 庞业滨 He Qing;Li Jing;Song Honglin(Gynecological Tumor Area,Guangxi Medical University Affiliated Tumor Hospital,Nanning530021;Guangxi Medical University,Nanning530000)

机构地区：[1]广西医科大学附属肿瘤医院,南宁530021 [2]广西医科大学,南宁530000

出　　处：《现代妇产科进展》2018年第12期910-913,共4页Progress in Obstetrics and Gynecology

基　　金：广西壮族自治区卫生和计划生育委员会科研课题资助项目(No:Z2015597;No:Z2015705);广西医疗卫生适宜技术研究与开发资助项目(No:S201510)

摘　　要：目的:探讨局部晚期宫颈癌根治性放化疗患者中^(18)F-FDG PET/CT中体积代谢参数和临床病理因素对预后的影响。方法:回顾分析52例行根治性放疗的局部晚期宫颈癌患者,治疗前均行^(18)F-FDG PET/CT全身显像检查,代谢体积参数如最大标准摄取值(SUVmax)、最大标准平均值(SUVmean)、代谢肿瘤体积(MTV)、肿瘤体积内总糖酵解活性(TGV)可从PET/CT得到。生存曲线采用Kaplan-Meier方法计算,对患者预后的影响因素分析采用单因素Log-rank检验,多因素分析采用COX等比例风险模型。结果:52例患者随访时间7～77月,平均34.6个月。单因素分析显示,FIGO分期(P<0.05,P <0.05)、TGV(714cm^3; P<0.05,P<0.05)、淋巴结转移(P<0.005,P<0.005)认为对PFS、OS有统计学差异。多因素分析结果示,TGV对局部晚期宫颈癌的预后有统计学意义(P<0.05)。结论:TGV可能是预测宫颈癌无病生存率和总生存率的一个重要独立预后因素。Objective:To compare the prognostic value of different anatomical and functional metabolic parameters determined using 18F-FDG PET/CT with other clinical and pathological prognostic parameters in locally advanced cervical radical radiotherapy(LACC).Methods:Fifty-two patients with LACC treated with standard curative doses of chemo-radiotherapy(CRT)underwent pre-therapy 18F-FDG PET/CT.18F-FDG PET/CT parameters including maximum and mean tumor standardized uptake values(SUVmax,SUVmean),metabolic tumor volume(MTV)and tumor glycolytic volume(TGV)were measured before the start of CRT.These parameters were compared to other clinical prognostic factors.Survival curves were estimated by using the Kaplan-Meier method.COX regression analysis was performed to determine the independent contribution of each prognostic factor.Results:After 34.6 months of mean follow-up(range,7~77months).In univariate analysis,International Federation of Gynecology and Obstetrics stage(P<0.05,P<0.05),lymph node statuson PET(P<0.05,P<0.05),and TGV(cutoff,714;P<0.05,P<0.05)were significant predictors of PFS and OS.In multivariate analysis,only TGV were independent prognostic factors for predicting PFS and OS(P<0.05,P<0.05).Conclusions:In uterine cervical cancer,TGV,a volume-based metabolic parameter may be significant independent prognostic factors for progression-free survival(PFS),progression-free survival(PFS)and overall survival(OS).

关 键 词：宫颈癌 同步放化疗 TGV SUV 

分 类 号：R737.33[医药卫生—肿瘤]