^(18)F-FDG PET/CT代谢体积参数对复发性宫颈癌的预后预测及其与外周血NLR、PLR相关性的研究  

Prognostic prediction of ^(18)F-FDG PET/CT metabolic volume parameters for recurrent cervical cancer and its correlation with peripheral blood NLR and PLR

作　　者：訾刚[1] 袁超[1] 刘红丽[2] 李卫鹏[1] 李辉[1] 沈如月 陈雪梅 Zi Gang;Yuan Chao;Liu Hongli;Weipeng Li;Li Hui;Shen Ruyue;Chen Xuemei(Department of Nuclear Medicine,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;Department of Gynecological Oncology,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院核医学科,蚌埠233004 [2]蚌埠医学院第一附属医院肿瘤妇科,蚌埠233004

出　　处：《国际放射医学核医学杂志》2023年第2期69-80,共12页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：安徽省蚌埠医学院自然科学基金(2020byzd095、BYKY18110)。

摘　　要：目的:探讨^(18)F-氟脱氧葡萄糖(FDG)PET/CT代谢体积参数肿瘤代谢体积(MTV)和病灶糖酵解总量(TLG)对复发性宫颈癌患者生存预后预测的价值,以及其与外周血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)的关系。方法:回顾性分析2014年1月至2020年12月在蚌埠医学院第一附属医院行18F-FDG PET/CT检查并被纳入研究的50例复发性宫颈癌患者[中位年龄为52(45,66)岁]的临床资料和影像资料,得到最大标准化摄取值(SUV max)和阈值为40%SUV max、50%SUV max时的体积参数:全身MTV40%(wbMTV40%)、wbMTV50%和全身TLG40%(wbTLG40%)、wbTLG50%。评价这些18F-FDG PET/CT代谢体积参数与无进展生存率(PFS)和总生存率(OS)的关系,以及其与外周血NLR、PLR的相关性。根据有无再次复发和死亡危险将患者分为无再次复发、再次复发和死亡3组。对患者的FIGO分期(Ⅰ+Ⅱ对Ⅲ+Ⅳ)、病理类型(鳞癌对腺癌)、复发部位(盆腔复发对远处复发)、初始治疗时的放射治疗(是对否)、复发后治疗(手术对非手术)和复发时的年龄(≥60.0岁对<60.0岁)进行危险分组;而患者的连续变量(NLR、PLR和^(18)F-FDG PET/CT代谢体积参数)则根据最佳临界值分为高、低组。采用Chi-square检验分析分类变量在各组间的差异。采用受试者工作特征曲线评估^(18)F-FDG PET/CT代谢体积参数对PFS及OS的预测效能并确定最佳临界值;再用Youden指数分析判定最佳临界值,进而确定最佳^(18)F-FDG PET/CT代谢体积参数。采用Kaplan-Meier法绘制预测患者PFS及OS的生存曲线,采用Log-rank法对组间生存曲线进行检验。采用Cox回归模型对复发性宫颈癌患者各项可能的预后因素进行单因素和多因素分析。将单因素分析中P<0.05的变量纳入多因素回归分析中,得到PFS和OS的独立预测因素。采用Spearman相关分析法分析^(18)F-FDG PET/CT代谢体积参数与外周血NLR、PLR的相关性。结果:所有患者初始�Objective To investigate the value of ^(18)F-fluorodeoxyglucose(FDG)PET/CT metabolic volume parameters metabolic tumor volume(MTV)and total lesion glycolysis(TLG)in predicting the survival and prognosis prediction of patients with recurrent cervical cancer and their relationship with peripheral blood neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR).Methods The clinical and imaging data of 50 patients(the median age was 52(45,66)years)with recurrent cervical cancer who underwent ^(18)F-FDG PET/CT whole body imaging at the First Affiliated Hospital of Bengbu Medical College from January 2014 to December 2020 were retrospectively analyzed.The volume parameters with maximum standard uptake value(SUVmax)and SUVmax thresholds of 40%and 50%were obtained:whole body MTV40%(wbMTV40%),wbMTV50%and whole body TLG40%(wbTLG40%),wbTLG50%.To evaluate the relationship between these ^(18)F-FDG PET/CT metabolic volume parameters and progression free survival(PFS)and overall survival(OS),as well as the correlation with peripheral blood NLR and PLR.Patients were divided into three groups based on whether they had recurrence and the risk of death:non recurrence,recurrence,and death.For survival analysis,the patients were divided into risk groups based on their FIGO stage(Ⅰ+Ⅱvs.Ⅲ+Ⅳ),pathological type(squamous cell carcinoma vs.adenocarcinoma),location of recurrence(pelvic recurrence vs.distant recurrence),initial treatment with radiotherapy(Yes vs.No),postoperative treatment(surgery vs.non surgery),and age at the time of recurrence(≥60.0 years vs.<60.0 years).The continuous variables of patients(NLR,PLR,and ^(18)F-FDG PET/CT metabolic volume parameters)were divided into high and low groups based on the optimal threshold.Chi-square test was used to analyze the differences between groups of categorical variables.Receiver operating characteristic curve was used to evaluate the predictive effect of ^(18)F-FDG PET/CT metabolic volume parameters on PFS and OS and determine the optimal critical value.Youden in

关 键 词：宫颈肿瘤 正电子发射断层显像术 体层摄影术 X线计算机 预后 代谢体积参数 

分 类 号：R737.33[医药卫生—肿瘤]