^(68)Ga-FAP-2286 PET/CT对晚期消化系统恶性肿瘤治疗后的生存预测价值  

The value of^(68)Ga-FAP-2286 PET/CT in predicting the survival of patients with advanced digestive system malignant tumors after treatment

作　　者：裴文婕 张渝 张晋滔 黄占文 陈跃 PEI Wenjie;ZHANG Yu;ZHANG Jintao;HUANG Zhanwen;CHEN Yue(Department of Nuclear Medicine,Affiliated Hospital of Southwest Medical University,Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院核医学科,核医学与分子影像四川省重点实验室,四川泸州646000

出　　处：《肿瘤影像学》2024年第5期523-529,共7页Oncoradiology

基　　金：国家自然科学基金(U20A20384);2021年四川省卫生健康委员会医学科技项目(21ZD005);2022年第三批省级科技计划项目和新型冠状病毒科技攻关应急项目(2022YFS0608)。

摘　　要：目的:探究与临床参数相比,^(68)Ga-FAP-2286正电子发射体层成像(positron emission tomography,PET)/计算机体层成像(computed tomography,CT)是否可以识别总生存期(overall survival,OS)更短的晚期消化系统恶性肿瘤患者。方法:回顾并分析2023年4月—2024年6月于西南医科大学附属医院经病理学检查证实为晚期消化系统肿瘤且在经手术治疗、放化疗及靶向免疫治疗后行^(68)Ga-FAP-2286 PET/CT检查的患者的影像学资料与临床资料。通过手动分割肿瘤负荷[计算肿瘤体积、峰值/平均值/最大标准化摄取值(standard uptake value,SUV)、肿瘤背景比值(tumor-to-background ratio,TBR)和细胞表面上的肿瘤受体结合(tumor receptor binding,TRB),TRB定义为SUV_(mean)乘以肿瘤体积],对扫描进行目视和定量评估。临床参数包括性别、既往治疗的方式和年龄。成像后,记录OS。结果:本研究共纳入32例患者,其中男性22例,女性10例,年龄30~83岁。在单变量COX回归分析中,较高的TBR(HR=1.217,95%CI 1.022~1.448,P=0.027)、TRB(HR=1.001,95%CI 1.000~1.002,P=0.029)和淋巴结转移的存在(HR=3.783,95%CI 1.033~13.854,P=0.045)与较短的OS显著相关。较大的肿瘤体积有显著性趋势(HR=1.004,95%CI 1.000~1.009,P=0.066),而其他参数都不能预测OS。在多变量COX回归中,只有TRB被确定为OS的重要独立预后因素(HR=1.001,95%CI 1.000~1.003,P=0.018)。在Kaplan-Meier分析中,TRB高于中位数142、TBR高于中位数8.3和存在淋巴结转移与较短的OS相关。结论:在晚期消化系统恶性肿瘤中,通过^(68)Ga-FAP-2286 PET/CT检测到的TRB升高是OS的独立预测因子。Objective:To investigate whether^(68)Ga-FAP-2286 positron emission tomography(PET)/computed tomography(CT)could identify patients with advanced digestive malignancies with shorter overall survival(OS)compared to clinical parameters.Methods:The imaging data and clinical data of patients with advanced digestive system tumors confirmed by histopathological examination in the Affiliated Hospital of Southwest Medical University from April 2023 to June 2024 who underwent^(68)Ga-FAP-2286 PET/CT examination after surgical treatment,chemoradiotherapy and targeted immunotherapy were retrospectively analyzed.Scans were assessed visually and quantitatively by manually segmenting the tumor load[calculating tumor volume,peak/mean/maximum standardized uptake value(SUV),tumor-to-background ratio(TBR),and tumor receptor binding(TRB)on the cell surface,defined as SUV_(mean)multiplied by tumor volume].Clinical parameters included gender,prior treatment and age.After imaging,OS was recorded.Results:A total of 32 patients,22 males and 10 females,aged 30-83 years,were included in this study.In univariate COX regression analysis,higher TBR(HR=1.217,95%CI 1.022-1.448,P=0.027),higher TRB(HR=1.001,95%CI 1.000-1.002,P=0.029)and the presence of lymph node metastasis(HR=3.783,95%CI 1.033-13.854,P=0.045)were significantly associated with shorter OS.Larger tumor volume had a significant trend(HR=1.004,95%CI 1.000-1.009,P=0.066),while other parameters could not predict OS.In multivariate COX regression,only TRB was identified as an important independent prognostic factor for OS(HR=1.001,95%CI 1.000-1.003,P=0.018).In Kaplan-Meier analysis,TRB higher than median 142,TBR higher than median 8.3 and lymph node metastasis were associated with shorter OS.Conclusion:In advanced digestive system malignancies,elevated TRB detected by^(68)Ga-FAP-2286 PET/CT was an independent predictor of OS.

关 键 词：成纤维细胞活化蛋白 ^(68)Ga-FAP-2286 正电子发射体层成像/计算机体层成像 消化系统肿瘤 诊疗一体化 预测价值 

分 类 号：R735[医药卫生—肿瘤] R445.6[医药卫生—临床医学]