^(18)F-FDG PET/CT代谢参数联合临床病理特征对晚期结直肠癌患者KRAS基因突变的评估价值  

Evaluation value of ^(18)F-FDG PET/CT metabolic parameters combined with clinicopathological features on KRAS gene mutation in patients with advanced colorectal cancer

作　　者：庞丁华 丘文明 黄明捷 黄馨 肖国有[1] 劳永聪[1] PANG Dinghua;QIU Wenming;HUANG Mingjie;HUANG Xin;XIAO Guoyou;LAO Yongcong(Department of Nuclear Medicine,Guangxi Medical University Cancer Hospital&Guangxi Cancer Institute,Guangxi Clinical Key Construction Specialist Nuclear Medicine Department,Nanning 530021,Guangxi,China)

机构地区：[1]广西医科大学附属肿瘤医院核医学科,广西临床重点建设专科核医学科,广西南宁市530021

出　　处：《广西医学》2024年第3期376-381,共6页Guangxi Medical Journal

基　　金：广西科技计划项目(桂科AB19110015);广西生物靶向诊治研究重点实验室开放课题(GXSWBX202203,GXSWBX202204,GXSWBX202205)。

摘　　要：目的探讨^(18)F-氟代脱氧葡萄糖(^(18)F-FDG)PET/CT代谢参数联合临床病理特征对晚期结直肠癌患者鼠类肉瘤病毒癌基因(KRAS)基因突变的评估价值。方法回顾性分析64例晚期结直肠癌患者的临床资料。所有患者在治疗前均接受^(18)F-FDG PET/CT检查。分析最大标准化摄取值(SUV_(max))、不同阈值下的代谢肿瘤体积(MTV)和病变总糖酵解(TLG)、临床病理特征与患者KRAS基因突变状态之间的关系。通过多因素Logistic回归模型分析与患者KRAS基因突变相关的因素。采用受试者工作特征曲线分析^(18)F-FDG PET/CT代谢参数、临床病理特征及二者联合评估患者KRAS基因突变的效能。基于^(18)F-FDG PET/CT代谢参数和临床病理特征构建列线图模型。结果单因素和多因素Logistic回归分析结果显示,SUV_(max)≥19.55、MTV50%≥7.95、肿瘤组织中/高分化与患者KRAS基因突变有关。SUV_(max)、MTV50%和肿瘤组织分化程度评估患者KRAS基因突变的曲线下面积(AUC)分别为0.653、0.625和0.621,三者联合评估的AUC为0.800,均高于单个指标的AUC(P<0.05)。基于SUV_(max)、MTV50%和肿瘤组织分化程度构建的列线图模型的一致性指数为0.800,校准曲线与参考线基本拟合。结论^(18)F-FDG PET/CT的代谢参数SUV_(max)、MTV50%与晚期结直肠癌患者KRAS基因突变密切相关,联合肿瘤组织分化程度所构建的列线图模型对患者KRAS基因突变具有较高的评估价值。Objective To investigate the evaluation value of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)PET/CT metabolic parameters combined with clinicopathological features on Kirsten rat sarcoma viral oncogene homolog(KRAS)gene mutation in patients with advanced colorectal cancer.Methods The clinical data of 64 patients with advanced colorectal cancer were retrospectively analyzed.All patients underwent ^(18)F-FDG PET/CT examination before treatment.The relations of maximal standard uptake value(SUV_(max)),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)in different thresholds,clinicopathological features with KRAS gene mutation status of patients were analyzed.The multivariate Logistic regression model was used to analyze the factors related to KRAS gene mutation in patients.The receiver operating characteristic curve was employed to analyze ^(18)F-FDG PET/CT metabolic parameters,clinicopathological features,and the two as above for alone and jointly evaluating the efficiency of patients'KRAS gene mutation.A nomogram model was established based on ^(18)F-FDG PET/CT metabolic parameters and clinicopathological features.Results The results of univariate and multivariate Logistic regression analysis revealed that SUV_(max)≥19.55,MTV50%≥7.95,and tumor tissues with medium/high differentiation were related to patients'KRAS gene mutation.Areas under the curve(AUC)of SUV_(max),MTV50%,and differentiated degree of tumor tissues for evaluating patients'KRAS gene mutation were 0.653,0.625,and 0.621,respectively,and AUC of combined evaluation of the three was 0.800,which was higher than AUC of the single index(P<0.05).The consistency index of the nomogram model established based on SUV_(max),MTV50%,and differentiated degree of tumor tissues was 0.800,and the calibration curve basically fitted the reference line.Conclusion Metabolic parameters SUV_(max) and MTV50%of ^(18)F-FDG PET/CT are closely related to KRAS gene mutation in patients with advanced colorectal cancer.The nomogram model established by combining differentiated

关 键 词：结直肠癌 鼠类肉瘤病毒癌基因 ^(18)F-氟代脱氧葡萄糖 正电子发射计算机体层扫描 代谢参数 临床病理特征 列线图 预测价值 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]