^(18)F-FDG PET/CT在预测非小细胞肺癌EGFR突变中的价值  

Value of ^(18)F-FDG PET/CT in predicting EGFR mutations in non-small cell lung cancer

作　　者：曾樊顺 于丽娟[1,2] 马敬全 王欣[1] 梁邦玉[1] Zeng Fanshun;Yu Lijuan;Ma Jingquan;Wang Xin;Liang Bangyu(Department of Cancer Hospital,Harbin Medical University,Heilongjiang Harbin 150081,China;Hainan Cancer Hospital,Hainan Haikou 570100,China)

机构地区：[1]哈尔滨医科大学附属肿瘤医院,黑龙江哈尔滨150081 [2]海南省肿瘤医院,海南海口570100

出　　处：《现代肿瘤医学》2019年第5期787-790,共4页Journal of Modern Oncology

基　　金：国家自然科学基金(编号:81671771);海南省自然基金创新团队项目(编号:2018CXTD347)

摘　　要：目的:探讨^(18)F脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)正电子发射计算机断层显像(PET/CT)最大标准摄取值(maximum standardized uptake value,SUVmax)及代谢体积(metabolic tumor volume,MTV)在预测非小细胞肺癌(non-small cell lung cancer,NSCLC)表皮生长因子受体(epidermal growth factor receptor,EGFR)突变中的价值。方法:回顾性分析141例经病理证实的NSCLC患者的临床资料,所有患者治疗前均行^(18)F-FDG PET/CT检查及EGFR突变检测。分析临床病理资料和PET/CT代谢参数SUVmax、MTV与EGFR突变状态的相关性。采用受试者工作特征(receiver operating characteristic,ROC)曲线获得SUVmax、MTV预测EGFR突变的最佳界值点。采用Logistic回归模型对预测EGFR突变状态的变量进行多因素分析。结果:141例入组患者中,EGFR突变型有74例(52. 5%)。EGFR突变患者的MTV值明显低于野生型患者(P=0. 033),而EGFR突变患者的SUVmax与野生型患者的SUVmax间无统计学差异(P> 0. 05)。ROC曲线分析显示,SUVmax及MTV预测EGFR突变的最佳截断值分别是8. 56,24. 0 cm3,AUC分别是0. 522,0. 604。单因素分析结果显示,不吸烟者(P=0. 001)、女性(P=0. 003)、腺癌(P=0. 022)及MTV <24. 0 cm^3(P=0. 003)的患者更易出现EGFR突变。Logistic多因素分析显示,吸烟及MTV是预测EGFR突变的独立影响因子(P <0. 05)。结论:MTV是预测NSCLC EGFR突变的独立影响因素,在预测EGFR突变中具有一定的参考价值。Objective:To investigate the value of maximum standardized uptake value(SUV max),metabolic tumor volume(MTV)measured by 18 F-fluorodeoxyglucose positron emission tomography(18F-FDG PET/CT)in predicting the presence of epidermal growth factor receptor(EGFR)mutation status in non-small cell lung cancer(NSCLC).Methods:We retrospectively reviewed 141 patients with NSCLC confirmed by pathology,who underwent 18F-FDG PET/CT examination and EGFR mutation analysis before any treatment.To analyze the correlation between clinical pathological data and PET/CT metabolic parameters SUVmax,MTV and EGFR mutations.Receiver operating characteristic(ROC)curve was used to identify the cutoffs of SUVmax,MTV.Multivariate Logistic regression analysis was used to analyze predictors of EGFR mutations.Results:In 141 patients enrolled in the study,EGFR mutations were identified in 74 patients(52.5%).Patients with EGFR mutations had significantly lower MTV than those with wild-type EGFR(P=0.033).No statistically significant correlation with SUV max was found between patients with mutant and wild-type EGFR(P>0.05).ROC curve showed that the optimal cut-off for SUV max,MTV to predict EGFR mutations were 8.56,24.0 cm^3 respectively,with AUC of 0.522,0.604 respectively.Univariate analysis showed that non-smokers(P=0.001),females(P=0.003),patients with adenocarcinoma(P=0.022)and MTV<24.0 cm^3(P=0.003)were more likely to be EGFR mutation.Multivariate analysis showed that smoking status and MTV remained a significant predictors for EGFR mutation(P<0.05).Conclusion:MTV is an independent predictor of EGFR mutations in NSCLC,and has certain reference value in predicting EGFR mutation.

关 键 词：非小细胞肺癌 18F脱氧葡萄糖正电子发射计算机断层显像 表皮生长因子受体 

分 类 号：R734.2[医药卫生—肿瘤]