18F-FDG PET/CT代谢参数对儿童神经母细胞瘤MYCN基因扩增的预测价值及预后评估  

Predictive value and prognostic assessment of 18F⁃FDG PET/CT metabolic parameters for MYCN gene amplification in pediatric neuroblastoma

作　　者：周莹 涂宁 冯洪燕 周欣 杨华杰 卜丽红 ZHOU Ying;TU Ning;FENG Hongyan;ZHOU Xin;YANG Huajie;BU Lihong(PET Center and Molecular Imaging Center,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Dept.of Nuclear Medicine,Yihe Hospital of Henan University,Zhengzhou 450047,Henan,China)

机构地区：[1]武汉大学人民医院PET中心暨分子影像中心,湖北武汉430060 [2]河南大学附属郑州颐和医院核医学科,河南郑州450047

出　　处：《武汉大学学报（医学版）》2024年第8期928-932,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨18F-FDG PET/CT相关代谢参数对儿童神经母细胞瘤(NB)MYCN基因扩增的预测价值及预后评估。方法:回顾性选取2019年1月至2022年12月期间65例NB儿童作为研究对象,所有患儿均在治疗前进行了18F-FDG PET/CT诊断及经手术病理确诊。记录患儿MYCN基因扩增状态,测量病灶不同的PET代谢参数,包括最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))、代谢肿瘤体积(MTV)及病灶糖酵解总量(TLG),随访内容包括肿瘤进展、复发及死亡并记录时间。采用Kaplan-Meier生存曲线分析MYCN基因扩增与NB进展、复发及死亡之间的相关性,比较各参数在MYCN基因扩增与未扩增组间差异。使用ROC曲线确定PET代谢参数预测MYCN扩增的最佳临界值。采用Cox模型进行多因素预后分析。结果:本组MYCN基因扩增与NB进展、复发相关(χ^(2)=8.478,P=0.004;χ^(2)=6.326,P=0.012)。PET代谢参数SUV_(max)、SUV_(mean)及TLG与MYCN基因扩增有显著相关性(均为P<0.05),预测MYCN基因扩增最佳临界值分别为5.55、4.45及929.10。SUV_(max)与NB进展显著相关,SUV_(max)、SUV_(mean)、TLG与复发显著相关,SUV_(max)与死亡显著相关(均为P<0.05)。结论:NB患儿治疗前18F-FDG PET/CT的SUV_(max)>5.55、SUV_(mean)>4.45及TLG>929.1,极有可能伴有MYCN扩增,可作为NB进展、复发预测指标之一。Objective To investigate the predictive value and prognostic assessment of 18F⁃FDG PET/CT metabolic parameters for MYCN gene amplification in pediatric neuroblastoma(NB).Methods A total of 65 cases of NB confirmed by pathology and examined by 18F⁃FDG PET/CT from January 2019 to December 2022 were retrospectively selected as the research objects.The MYCN gene amplification status of the children was recorded,and different PET metabolic parameters(SUV_(max),SUV_(mean),MTV,and TLG)of the lesions were measured.Follow⁃up information included tumor progression,recurrence,and death,as well as their time⁃points,were recorded.The correlation between MYCN gene amplification and NB progression,recurrence,and death was analyzed using Kaplan⁃Meier survival curves,and the differences in each parameter were compared between the MYCN gene amplified and unamplified groups.ROC curves were used to determine the optimal threshold values for PET/CT metabolic parameters to predict MYCN amplification.Multifactorial prognostic analysis was performed using the Cox model.Results In this group,MYCN gene amplification was correlated with NB progression and recurrence(χ^(2)=8.478,P=0.004;χ^(2)=6.326,P=0.012).SUV_(max),SUV_(mean),and TLG were significantly correlated with MYCN gene amplification(all P<0.05).The predicted optimal thresholds for MYCN gene amplification SUV_(max),SUV_(mean),and TLG were 5.55,4.45,and 929.10,respectively.SUV_(max) was significantly correlated with the progression of NB,SUV_(max),and SUV_(mean),TLG were significantly correlated with recurrence,and SUV_(max) was significantly correlated with death(all P<0.05).Conclusion Pre⁃treatment 18F⁃FDG PET/CT SUV_(max)>5.55,SUV_(mean)>4.45,and TLG>929.1 in pediatric NB are highly likely to be accompanied by MYCN amplification and serve as the predictors of progression and recurrence for the disease.

关 键 词：神经母细胞瘤 MYCN 儿科 PET/CT 代谢参数 

分 类 号：R816.92[医药卫生—放射医学]