18F-FDG PET/CT相关参数对肺癌患者125I粒子植入术后短期疗效的预测价值  

The clinical value of the relevant parameters of pre-treatment 18F-FDG PET-CT in predicting the short-term efficacy of radioactive 125I seed implantation in patients with lung cancer

作　　者：胡天鹏 沈婕 邵梦麟 丁恩慈 HU Tianpeng;SHEN Jie;SHAO Menglin;DING Enci(Department of Nuclear Medicine,First Central Clinical School of Tianjin Medical University,Tianjin 300192,China)

机构地区：[1]天津医科大学一中心临床学院核医学科,300192

出　　处：《介入放射学杂志》2022年第6期577-581,共5页Journal of Interventional Radiology

基　　金：天津市卫生健康科技面上项目(TJWJ2021MS013)。

摘　　要：目的 探讨肺癌患者^(125)I粒子植入(radioactive iodine-125 seed implantation,RISI)治疗的短期临床疗效及18F-FDG PET-CT相关代谢参数对RISI术后短期疗效的预测价值.方法 回顾性分析49例接受RISI治疗肺癌患者的临床资料.采用Kaplan-Meier法分析生存率和二元logistic回归分析术后即刻D90、性别、吸烟史、病理类型、年龄、肿瘤最大直径、肿瘤代谢体积(metabolic tumor volume,MTV)、SUVmax、SUVpeak、SUVmean、TLG及CEA与RISI术后短期疗效的关系.结果 49例患者术后1个月CR 0例,PR 4例,有效率为8.1%;3个月后CR 2例,PR 27例,有效率为59.2%;6个月后CR 6例,PR 26例,SD 12例,PD 5例,有效率为65.3%,中位生存时间为21.0个月.术后即刻D90[β=0.66,SE=0.32,Wald=4.289,P=0.038,OR(95%CI)=1.069(1.004~1.138)]、MTV[β=-0.11,SE=0.052,Wald=4.381,P=0.036,OR(95%CI)=0.896(0.809~0.993)]是预测术后6个月疗效的独立影响因素.MTV的预测准确度为中等:AUC=0.796,cutoff值=53.11,灵敏度=75%,特异度=76.5%,P=0.001;而D90的预测准确度较低:AUC=0.656,P=0.074.结论 18F-FDG PET/CT显像中的MTV与术后即刻D90对于预测肺癌患者RISI术后6个月疗效具有良好的价值.Objective To investigate the short-term clinical effect of radioactive ^(125)I seed implantation(RISI)in treating patients with non-small cell lung cancer(NSCLC),and to discuss the value of the relevant parameters of pre-treatment ^(18)F-FDG PET-CT in predicting the short-term efficacy of RISI.Methods The clinical data of 49 patients with NSCLC,who were treated with RISI at the Tianjin Municipal First Central Hospital of China between January 2016 and December 2018,were retrospectively analyzed.By using KaplanMeier method the survival rate was analyzed,and binary logistic regression analysis was used to evaluate the correlation between the post-RISI instant D90,gender,smoking history,pathological pattern,age,maximum tumor diameter,metabolic tumor volume(MTV),SUVmax,SUVpeak,SUVmean,TLG,CEA and the post-RISI short-term efficacy.Results One month after RISI,complete remission(CR)was achieved in 0 patient and partial remission(PR)in 4 patients,the effective rate was 8.1%.Three months after RISI,CR was obtained in 2 patients and PR in 27 patients,the effective rate was 59.2%.Six months after RISI,CR was obtained in 6 patients,PR in 26 patients and stable disease(SD)in 12 patients,the effective rate was 65.3%.The median survival time was 21.0 months.The post-RISI instant D90[β=0.66,SE=0.32,Wald value=4.289,P=0.038,OR(95%CI)=1.069(1.004-1.138)]and the MTV[β=-0.11,SE=0.052 Wald value=4.381,P=0.036,OR(95%CI)=0.896(0.809-0.993)]were the independent influencing factors for predicting the post-RISI 6-month curative efficacy.The prediction accuracy of MTV was moderate(AUC=0.796,cutoff value=53.11,sensitivity=75%,specificity=76.5%,P=0.001),while the prediction accuracy of D90 was low(AUC=0.656,P=0.074).Conclusion The parameter of MTV in ^(18)F-FDG PET/CT imaging and the post-RISI instant D90 have good value in predicting post-RISI 6-month short-term curative efficacy for patients with NSCLC.

关 键 词：MTV 125I粒子 术后即刻D90 预测价值 非小细胞肺癌 

分 类 号：R734.2[医药卫生—肿瘤]