肺腺癌患者18F-FDG PET/CT半定量参数与EGFR基因突变亚型的关系  

Relationships of semiquantitative parameters assessed on 18F-FDG PET/CT and EGFR mutation subtypes in lung adenocarcinoma patients

作　　者：廖栩鹤[1] 刘萌[1] 王荣福[1] 陈雪祺[1] 崔永刚[1] 邸丽娟[1] 殷雷[1] 佟正灏 孙宏伟[1] 吴彩霞 LIAO Xuhe;LIU Meng;WANG Rongfu;CHEN Xueqi;CUI Yonggang;DI Lijuan;YIN Lei;TONG Zhenghao;SUN Hongwei;WU Caixia(Department of Nuclear Medicine,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院核医学科

出　　处：《中国介入影像与治疗学》2020年第2期98-103,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：“十二五”国家支撑项目基金(2014BAA03B03);北京大学临床医学+X青年专项(PKU2018LCXQ012);北京大学第一医院自然科学基金(2017QN14)

摘　　要：目的探讨肺腺癌患者18 F-FDG PET/CT半定量参数与表皮生长因子受体(EGFR)基因突变亚型间(19号外显子缺失突变和21号外显子点突变)的关系。方法收集64例肺腺癌患者术前18 F-FDG PET/CT及EGFR基因突变资料。葡萄糖代谢显像原发灶半定量参数包括最大标准化摄取值(SUV max)、平均标准化摄取值(SUV mean)、肿瘤代谢体积(MTV)和总糖酵解量(TLG)。经单因素和多因素Logistic回归分析评估各参数与突变亚型间的关系,通过AUC评估关联效能。结果19号、21号外显子突变比例为23∶41。单因素分析显示,作为连续变量,原发灶最大径较小[OR=0.942,95%CI(0.890,0.998)]及低水平原发灶MTV(pMTV)[OR=0.957,95%CI(0.923,0.991)]更可能是21号外显子点突变;作为分类变量,原发灶最大径较小[<26.5 mm:OR=3.759,95%CI(1.284,11.005)]、高水平SUV mean[≥4.35:OR=4.267,95%CI(1.088,16.726)]及低水平pMTV[<11.2 cm 3,OR=7.000,95%CI(1.798,27.253)]更易发生21号外显子点突变。多因素分析仅发现分类变量低水平pMTV更易发生21号外显子点突变(OR=8.093,P=0.041)。结论EGFR基因突变肺腺癌患者原发灶18 F-FDG PET/CT半定量参数可能与19和21号外显子突变亚型存在一定相关性,但关联程度有限。Objective To explore the relationships of 18 F-FDG standardized uptake value(SUV)-derived parameters and mutation subtypes(deletions in exon 19 and a mutation in exon 21)in lung adenocarcinoma patients with mutant epidermal growth factor receptor(EGFR)gene.Methods Data of 64 lung adenocarcinoma patients who underwent 18 F-FDG PET/CT scans and EGFR gene mutation test were collected.The relationships of subtype mutation of EGFR gene with four parameters(maximum standardized uptake value[SUV max],average of standardized uptake value[SUV mean],metabolic tumor volume[MTV]and total lesion glycolysis[TLG])of primary lesion based on 18 F-FDG PET/CT and clinical characteristics were evaluated with univariate and multivariate Logistic regression,respectively.Results The mutant ratio of exon 19 and exon 21 was 23∶41.When the parameters were continuous variables,univariate Logistic regression showed exon 21 mutations were found more frequently in the EGFR-positive patients with shorter maximum diameter of primary lesion(OR=0.942,95%CI[0.890,0.998])and low level of MTV of primary lesion(pMTV)(OR=0.957,95%CI[0.923,0.991]).As dichotomous variables,in univariate regression shorter maximum diameter of primary lesion(<26.5 mm:OR=3.759,95%CI[1.284,11.005]),high level SUV mean(≥4.35:OR=4.267,95%CI[1.088,16.726]),low level pMTV(<11.2 cm 3:OR=7.000,95%CI[1.798,27.253])would be significantly related to mutant exon 21.The multivariate Logistic regression displayed that low level of pMTV were found more frequently in exon 21 mutations(OR=8.093,P=0.041).Conclusion The primary-lesion SUV-derived parameters from 18 F-FDG PET/CT of lung adenocarcinoma patients with EGFR-gene mutation associate with the mutant subtypes(exon 19 and 21 mutation)to some extent,but this correlation might be limited.

关 键 词：肺肿瘤 腺癌 正电子发射断层显像术 氟脱氧葡萄糖F18 表皮生长因子受体 

分 类 号：R734.2[医药卫生—肿瘤] R817[医药卫生—临床医学]