^(18)F-FDG PET/CT测算病灶糖酵解总量预测食管癌患者经放射及化学治疗预后  

^(18)F-FDG PET/CT measurement of total lesion glycolysis for predicting prognosis of patients with esophageal cancer after radiotherapy and chemotherapy

作　　者：汤泊 周东亚 刘敏 李天女[2] 丁重阳[2] TANG Bo;ZHOU Dongya;LIU Min;LI Tiannyu;DING Chongyang(Department of Radiology,ShuYang Hospital of TCM,Suqian 223600,China;Department of Nuclear Medicine,the First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]沭阳县中医院放射科,江苏宿迁223600 [2]南京医科大学第一附属医院核医学科,江苏南京210029

出　　处：《中国医学影像技术》2021年第11期1680-1684,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察^(18) F-FDG PET/CT测算病灶糖酵解总量(TLG)预测食管癌患者经放射化学治疗(简称放化疗)后预后的价值。方法回顾性分析131例接受放化疗的食管癌患者的临床资料、治疗前^(18) F-FDG PET/CT资料及随访资料。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),观察肿瘤最大标准摄取值(SUV max)、原发病灶TLG(TLG p)及全身病灶TLG(TLG wb)等评估预后的价值。结果131例食管癌均表现为^(18) F-FDG高摄取,原发灶SUV max、TLG p和TLG wb分别为16.29(7.52,30.12)、90.15(17.68,501.89)及150.55(22.69,798.87)。随访期内63例患者死于食管癌。根据SUV max、TLG p及TLG wb预测患者总生存期的最佳截断值分别为12.59、84.03及176.10。N分期、M分期及TLG wb是影响预后的独立危险因素(P均<0.05)。TLG wb≤176.10患者3年总生存率明显高于TLG wb>176.10者(P<0.001)。结论食管癌放化疗前^(18) F-FDG PET/CT测算的TLG wb及N分期和M分期是影响患者预后的独立危险因素;TLG wb>176.10提示预后较差。Objective To observe the value of ^(18)F-FDG PET/CT measurement of total lesion glycolysis(TLG)for predicting prognosis of patients with esophageal cancer after radiotherapy and chemotherapy.Methods Clinical data,^(18)F-FDG PET/CT data before and after radiotherapy and chemotherapy and during following-up of 131 esophageal cancer patients were retrospectively analyzed.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated to observe the value of the maximum standardized uptake value(SUV_(max)),TLG of primary lesion(TLG_(p))and whole-body TLG(TLG wb)for evaluating prognosis of these patients.Results The primary lesions of all 131 cases showed high ^(18)F-FDG uptakes,and the SUV_(max),TLG_(p) and TLG_(wb)was 16.29(7.52,30.12),90.15(17.68,501.89)and 150.55(22.69,798.87),respectively.During following-up,63 patients died of esophageal cancer.The best cut-off value of SUV_(max),TLG_(p) and TLG_(wb) for predicting overall survival was 12.59,84.03 and 176.10,respectively.N stage,M stage and TLG_(wb) were all independent risk factors for prognosis(all P<0.05).The 3-year overall survival rate of patients with TLG_(wb)≤176.10 was significantly higher than that of patients with TLG_(wb)>176.10(P<0.001).Conclusion Before treatment,^(18)F-FDG PET/CT measurement of TLG_(wb),N stage and M stage were independent risk factors for prognosis of esophageal cancer patients after radiotherapy and chemotherapy.TLG_(wb)>176.10 indicated poor prognosis.

关 键 词：食管肿瘤 正电子发射断层显像 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R735.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]