基于18F-FDG PET/CT参数评价不同EGFR基因状态晚期肺腺癌患者放化疗疗效预测价值  

Assessment of the Predictive Value of Chemoradiotherapy in Patients with Advanced Lung Adenocarcinoma with Different EGFR Gene Status based on18F-FDG PET/CT Parameters

作　　者：黄健[1] 邓燕云[1] 黄东宁[1] 覃莉[1] Huang Jian;Deng Yanyun;Huang Dongning;Qin Li(Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, 545005)

机构地区：[1]广西医科大学第四附属医院

出　　处：《基因组学与应用生物学》2019年第5期2420-2426,共7页Genomics and Applied Biology

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016168)和(Z20170896)共同资助

摘　　要：为评价18F-FDG PET/CT参数对不同表皮生长因子受体(epithelial growth factor receptor, EGFR)基因状态晚期肺腺癌患者同步放化疗的疗效预测价值,本研究选择2016年1月至2018年2月我院初诊的100例晚期肺腺癌患者,比较不同EGFR基因状态下晚期肺腺癌患者同步放化疗治疗的临床疗效,并对18F-FDG PET/CT显像中原发病灶的各项代谢参数,代谢肿瘤体积(MTV)、最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)和总肿瘤糖酵解(TLG)值,以预测不同EGFR基因状态晚期肺腺癌患者同步放化疗效果的受试者工作特征曲线(receiveroperatingcharacteristiccurve,ROC曲线),并进行分析。结果显示,SUVmax预测不考虑EGFR基因状态的晚期肺腺癌患者放化疗疗效的截断值为9.50 (AUC=0.715,敏感度=79.7%,特异性=61%,p=0.031),SUVmax预测EGFR野生型的晚期肺腺癌患者放化疗疗效的截断值为9.50 (敏感度=82.4%,特异性=64.3%, p=0.014)。MTV预测EGFR 19号及21号外显子突变的晚期肺腺癌患者放化疗疗效的截断值分别为93.50(敏感度=63.6%,特异性=92.3%, p=0.021),77.00 (敏感度=83.3%,特异性=69.2%, p=0.041)。综上所述,对于EGFR基因状态不明的肺腺癌患者,SUVmax值可较好的预测放化疗效果,尤其是对于EGFR野生型患者;当EGFR19号及21号外显子突变时,MTV值预测结果优于SUVmax值。In order to investigate the predictive value of 18F-FDG PET/CT parameters for concurrent chemoradiotherapy in patients with advanced lung adenocarcinoma with different EGFR gene status. The clinical data and PET-CT imaging data of 100 patients with advanced lung adenocarcinoma diagnosed in our hospital from January 2017 to April 2018 were retrospectively analyzed, and the 18F-FDG PET/CT metabolic parameters of the original non-small cell lung cancer(MTV, SUVmax, SUVmean, TLG) before and after chemotherapy were compared and analyzed in different states of EGFR gene and the clinical effect. The results exhibited that SUVmax predicted a truncated value of 9.5(AUC=0.715, sensitivity=79.7%, specific=61%, p=0.031) for advanced lung adenocarcinoma patients who did not consider the EGFR gene state, and SUVmax predicted that the truncated value of radiotherapy andchemotherapy for patients with advanced lung adenocarcinoma of EGFR wild type was 9.5(sensitivity =82.4%,specificity=64.3%, p=0.014). MTV predicted that the truncated value of chemotherapy for advanced lung adenocarcinoma patients with EGFR 19 and exon 21 mutations was 93.5(sensitivity=63.6%, specific=92.3%, p=0.021),and 77(sensitivity=83.3%, specific=69.2%, p=0.041). In summary, for lung adenocarcinoma with unknown EGFR gene status, SUVmax has a higher predictive value for chemotherapy and radiotherapy. When the EGFR gene state of the patients with lung adenocarcinoma was EGFR wild, the SUVmax value was used to predict the mutation,and the MTV value was better than the SUVmax value when the mutation of EGFR 19 and exon 21.

关 键 词：18F-FDG PET/CT 表皮生长因子受体(EGFR) 晚期肺腺癌 放化疗 

分 类 号：R734.2[医药卫生—肿瘤]