术前^(18)F-FDG PET/CT成像在非小细胞肺癌预后评估中的临床价值  

Clinical value of preoperative ^(18)F-FDG PET/CT imaging in prognostic assessment of non-small cell lung cancer

作　　者：罗靓洁 LUO Jingjie(Department of Nuclear Medicine,Second Affiliated Hospital of Army Medical University,Chongqing 400030,China)

机构地区：[1]陆军军医大学第二附属医院核医学科,重庆400030

出　　处：《临床与病理杂志》2021年第10期2260-2266,共7页Journal of Clinical and Pathological Research

摘　　要：目的:探讨术前18F-氟代脱氧葡萄糖(fluorodeoxyglucose,FDG)正电子发射计算机断层显像(positron emission tomography/computed tomography,PET/CT)在非小细胞肺癌(non-small cell lung cancer,NSCLC)预后评估中的临床应用价值。方法:回顾性选取2015年1月至2017年1月于陆军军医大学第二附属医院行NSCLC根治术的Ⅲ期鳞癌患者85例作为研究对象,根据患者^(18)F-FDG PETCT资料记录患者肺原发灶最大标准摄取值(maximum standardized uptake value,SUVmax)、肿瘤代谢体积(metabolic tumor volume,MTV)及肿瘤糖酵解总量(total lesion glycolysis,TLG),采用受试者工作特征(receiver operating characteristic,ROC)曲线获取SUVmax、MTV及TLG的预测患者总生存期(overall survival,OS)的最佳临界值,筛选有统计学意义的指标分析其与临床病理特征之间是否存在关系,并依据临界值分组,比较各组之间OS的差别,并对影响预后的危险因素进行分析。结果:ROC曲线分析结果显示SUV_(max)具有较高预测OS价值(P<0.05),而MTV及TLG预测价值较低(P>0.05),SUVmax临界值为9.09时约登指数最大为0.73;SUV_(max)与患者年龄、性别、肿瘤直径、病理类型及肿瘤分化程度均无明显关系(P>0.05);单因素分析显示:肿瘤直径≥3 cm、肿瘤高分化、局SUVmax、高MTV、高TLG均为患者OS的影响因素(P<0.05);COX回归分析显示:高SUV_(max)是影响患者生存时间的独立危险因素(P<0.05)。结论:NSCLC根治术前^(18)F-FDG PET-CT显像中的原发灶SUV_(max)对于预测患者术后生存期具有重要临床价值。Objective:To study the clinical application value of preoperative ^(18)F-fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(PET/CT)in prognostic assessment of non-small cell lung cancer(NSCLC).Methods:Eighty-five patients with stage III squamous cell carcinoma who underwent radical NSCLC surgery in our hospital from January 2015 to January 2017 were retrospectively selected as the research subjects.According to ^(18)F-FDG PET-CT data of patients,the maximum standard uptake value(SUVmax),tumor metabolic volume(MTV)and tumor total glycolysis(TLG)of patients with primary lung lesions were recorded.The optimal critical values of SUVmax,MTV and TLG for predicting the total survival time(OS)of patients were obtained by using the receiver operating characteristic(ROC)curve.Statistically significant indexes were screened to analyze whether there was any relationship between SUVmax,MTV and TLG and clinicopathological features.According to the critical values,the differences of OS among each group were compared,and the risk factors affecting prognosis were analyzed.Results:The results of ROC analysis showed that SUV_(max) had a higher value in predicting OS(P<0.05),while MTV and TLG had a lower predictive value(P>0.05).When the critical value of SUVmax was 9.09,the maximum Youden index was 0.73.SUV_(max) had no significant relationship with age,gender,tumor diameter,pathological type and tumor differentiation degree(P>0.05).Univariate analysis showed that tumor diameter≥3 cm,tumor differentiation,high SUVmax,high MTV and high TLG were all influencing factors of OS in patients(P<0.05).COX regression analysis showed that high SUV_(max) was an independent risk factor affecting the survival time of patients(P<0.05).Conclusion:SUV_(max) of the primary lesion in ^(18)F-FDG PET-CT imaging before radical NSCLC surgery has important clinical value in predicting the postoperative survival time of patients.

关 键 词：^(18)F-FDG PET-CT显像 非小细胞肺癌 预后 临床价值 

分 类 号：R734.2[医药卫生—肿瘤]