PET/CT代谢参数与肺腺癌生物学特征关系分析及对脑转移的预测价值  

Analysis on the relationship between metabolic parameters of PET/CT and biological characteristics of lung adenocarcinoma and its predictive value for brain metastases

作　　者：游志鑫[1] 刘爱民[2] 冯小伟[1] 赵改花[3] 郝美静 霍红旗[1] YOU Zhi-xin;LIU Ai-min;FENG Xiao-wei(Department of Nuclear Medicine,Handan Central Hospital,Hebei 056001,China)

机构地区：[1]邯郸市中心医院核医学科,河北056001 [2]邯郸市中心医院精准医学科,河北056001 [3]邯郸市中心医院病案管理科,河北056001

出　　处：《中国临床新医学》2023年第7期700-704,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：河北省医学科学研究重点课题(编号:20171135)。

摘　　要：目的分析正电子发射断层成像/计算机断层显像(PET/CT)代谢参数与肺腺癌生物学特征的关系及对脑转移的预测价值。方法招募2020年2月至2022年4月邯郸市中心医院收治的肺腺癌患者103例,均进行PET/CT检查。分析肺腺癌生物学特征与患者病灶标准摄取值(SUV)最大值、瘦体重标准化摄取值(SUL)最大值的关联性。通过多因素logistic回归及列线图分析探讨SUV最大值、SUL最大值对肺腺癌脑转移的预测价值。结果淋巴结转移、T分期、分化程度与SUV最大值、SUL最大值存在显著关联(P<0.05)。多因素logistic回归分析结果显示,T分期为T _(3-4)期,以及较高水平的SUV最大值、SUL最大值是促进肺腺癌患者发生脑转移的独立危险因素(P<0.05)。列线图预测模型显示,SUV最大值、SUL最大值对肺腺癌患者脑转移具有较高预测价值,一致性指数分别为0.785、0.811。决策曲线分析(DCA)结果显示,在阈值0.35~0.71范围内,SUL最大值预测肺腺癌患者脑转移的净受益率优于SUV最大值。结论病灶SUV最大值、SUL最大值与肺腺癌淋巴结转移、T分期、分化程度等生物学特征具有关联性,临床可通过PET/CT检查及早预测患者脑转移情况,为临床治疗提供参考,改善患者预后。Objective To analyze the relationship between metabolic parameters of positron emission tomography/computed tomography(PET/CT)and biological characteristics of lung adenocarcinoma and its predictive value for brain metastases.Methods One hundred and three patients with lung adenocarcinoma who were admitted to Handan Central Hospital from February 2020 to April 2022 were recruited,and all the patients underwent PET/CT examination.The correlation between biological characteristics of lung adenocarcinoma and the maximum value of standard uptake value(SUV)and the maximum value of standard uptake value of lean body mass(SUL)of the patients′lesions were analyzed.The predictive value of SUV maximum value and SUL maximum value for brain metastases of lung adenocarcinoma were explored through multivariate logistic regression and nomogram analysis.Results Lymph node metastasis,T stage and differentiation degree were significantly correlated with SUV maximum value and SUL maximum value(P<0.05).The results of multivariate logistic regression analysis showed that T _(3-4) stage,and higher levels of SUV maximum value and SUL maximum value were independent risk factors for brain metastases in patients with lung adenocarcinoma(P<0.05).The nomogram prediction model showed that SUV maximum value and SUL maximum value had higher predictive value for brain metastases in patients with lung adenocarcinoma,and the consistency index was 0.785 and 0.811,respectively.The results of decision curve analysis(DCA)showed that the net benefit rate of SUL maximum value in predicting brain metastases in patients with lung adenocarcinoma was better than that of SUV maximum value within the threshold range of 0.35 to 0.71.Conclusion SUV maximum value and SUL maximum value in the lesions are correlated with the biological characteristics of lymph node metastasis,T stage and differentiation degree of lung adenocarcinoma.PET/CT examination can be used to predict the brain metastases of the patients as early as possible in clinic,so as to provide ref

关 键 词：正电子发射断层成像/计算机断层显像 肺腺癌 脑转移 标准摄取值 瘦体重标准化摄取值 

分 类 号：R445[医药卫生—影像医学与核医学]