18F-FDG PET/CT中不同部位SUVmax对预测初治转移鼻咽癌预后的价值  

Different-site SUVmax of 18F-FDG PET/CT in Predicting the Prognosis of Denovo Metastatic Nasopharyngeal Carcinoma

作　　者：张雪芳[1] 智生芳[2] 郑巧兰 吴国谦[4] 梁栩维 尹岫茅 张纯[1] ZHANG Xuefang;ZHI Shengfang;ZHENG Qiaolan;WUGuoqian;LIANG Xuwei;YIN Xiumao;ZHANG Chun(Department of Radiotherapy,Dongguan People's Hospital,Dongguan 523059,China;不详)

机构地区：[1]东莞市人民医院放疗科,广东东莞523059 [2]东莞市人民医院核医学科,广东东莞523059 [3]中山大学附属第三医院期刊中心,广东广州510630 [4]东莞市人民医院耳鼻喉科,广东东莞523059

出　　处：《中国医学影像学杂志》2019年第10期745-748,753,共5页Chinese Journal of Medical Imaging

基　　金：东莞市医疗卫生科技计划（2016105101005）

摘　　要：目的探讨18F-FDGPET/CT的最大标准化摄取值(SUVmax)预测初诊转移鼻咽癌预后的价值。资料与方法回顾性分析治疗前行病理活检及全身PET/CT检查,并确诊为初治远处转移的鼻咽癌患者159例。所有患者均行电话及门诊随访,中位随访时间17.95个月。评估18F-FDG PET/CT不同部位的SUVmax与总体生存期(OS)的相关性。通过Kaplan-Meier法计算患者6个月、1年、2年OS;应用Cox模型分析预后影响因素。结果159例患者中,单纯骨转移64例;未行化疗34例、疗程<4周期63例、>4周期62例;73例未行放疗、16例鼻咽部放疗剂量<68 Gy、70例>68 Gy。鼻咽部SUVmax(NP-SUVmax)7.00-15.00,中位数11.75;颈部SUVmax(NK-SUVmax)7.00-16.00,中位数11.72;转移灶SUVmax(M-SUVmax)5.00-11.25,中位数5.33。单因素分析发现,转移部位、化疗周期、放疗剂量及M?SUVmax是OS的影响因素;多因素分析发现,单纯骨转移、化疗>4周期以及低M-SUVmax患者OS更长。结论18F-FDGPET/CT转移灶的SUVmax对预测初诊转移的鼻咽癌患者的预后具有一定的价值。Purpose To explore the value of maximum standardized uptake value(SUVmax)of 18F-FDG PET/CT in predicting the prognosis of denovo metastatic nasopharyngeal carcinoma.Materials and Methods A total of 159 patients who underwent pathological biopsy and systemic PET/CT before treatment and were diagnosed as denovo metastasic nasopharyngeal carcinoma were analyzed retrospectively.All patients received telephone follow-up and outpatient follow-up,and the median follow-up time was 17.95 months.The correlation between the different-site SUVmax of 18F-FDG PET/CT and the overall survival(OS)were evaluated.The 6-month,one-year and two-year OS was calculated by Kaplan-Meier method,and the prognostic influencing factors were analyzed using the Cox model.Results Of 159 patients,64 patients developed simple osseous metastasis;34 patients did not undergo chemotherapy,63 patients had a course less than 4 cycles,and 62 patients had a course more than 4 cycles;73 patients did not receive radiotherapy,16 patients were treated with a radiotherapy dose less than 68 Gy at nasopharynx,and 70 patients with a radiotherapy dose more than 68 Gy.Nasopharynx SUVmax(NP-SUVmax)of 7.00-15.00,with median value 11.75;neck SUVmax(NK-SUVmax)of 7.00-16.00,with median value 11.72;metastasis SUVmax(M-SUVmax)of 5.00-11.25,with median value 5.33.Univariate analysis found that metastasis site,chemotherapy cycles and radiotherapy dose and M-SUVmax were prognostic factors for OS.Multivariate analysis showed that patients with simple osseous metastasis,more than 4 cycles of chemotherapy,and lower M-SUVmax had a longer OS.Conclusion The SUVmax of 18F-FDG PET/CT metastasis may have certain predicative value for predicting the prognosis of patients with denovo metastatic nasopharyngeal carcinoma.

关 键 词：鼻咽肿瘤 肿瘤转移 正电子发射断层显像计算机体层摄影术 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 参考值 预后 

分 类 号：R739.6[医药卫生—肿瘤] R445.3[医药卫生—临床医学]