FDG阳性的^(18)F-FDG PET/CT代谢参数与胃腺癌新辅助化疗后反应相关性研究  

The Correlation between Metabolic Parameters of FDG Positive ^(18)F-FDG PET/CT and Post Neoadjuvant Chemotherapy Response

作　　者：钱炫方 秦莉淋 嵇建峰 叶挺[2] 王运 易贺庆[2] 庞伟强[2] 龙斌[2] 李林法[2] QIAN Xuanfang;QIN Lilin;JI Jianfeng(The Second Affiliated College of Zhejiang Chinese Medical University,Zhejiang Cancer Hospital,Hangzhou Institute of Medicine Chinese Academy of Science,Hangzhou,Zhejiang Province 310022,P.R.China)

机构地区：[1]浙江中医药大学第二临床医学院,浙江省肿瘤医院中国科学院杭州医学研究所,杭州310022 [2]浙江省肿瘤医院中国科学院杭州医学研究所,杭州310022

出　　处：《临床放射学杂志》2024年第12期2094-2100,共7页Journal of Clinical Radiology

基　　金：国家卫生计生委科学研究基金——浙江省医药卫生重大科技计划立项课题(编号:WKJ_ZJ_1814)。

摘　　要：目的 探讨^(18)F-FDG PET/CT代谢参数及代谢异质性指数对胃腺癌患者新辅助化疗疗效的预测价值。方法 回顾性分析107例接受新辅助化疗的胃癌患者。搜集患者的临床信息、治疗前^(18)F-FDG PET/CT图像、术后病理结果。测量原发灶的SUVmax1、SUVmean1、MTV、TLG、肝脏的SUVmax2和SUVmean2,计算异质性指数-1(HI-1)、异质性指数-2(HI-2)及肿瘤肝脏摄取比(TLR),分析这些半定量参数及患者临床数据特征与患者化疗后反应(肿瘤消退分级)的相关性。结果 不同肿瘤消退分级组间T分期、M分期、脉管侵犯情况、神经侵犯情况、SUVmax1、SUVmean1、MTV、TLG、HI-1、HI-2及TLR差异有统计学意义(P<0.05)。在多因素分析中,SUVmax1、SUVmean1水平、存在远处转移及存在脉管侵犯是预测新辅助化疗疗效的独立危险因素。结论^(18)F-FDG PET/CT代谢参数结合临床特征可以一定程度预测胃腺癌患者新辅助化疗的疗效。Objective Exploring the predictive value of ^(18)F-FDG PET/CT metabolic parameters and metabolic heterogeneity index for the efficacy of neoadjuvant chemotherapy in patients with gastric adenocarcinoma.Methods Retrospective analysis of 107 gastric cancer patients receiving neoadjuvant chemotherapy.Collect clinical information of patients,pre treatment ^(18)F-FDG PET/CT images,and postoperative pathological results.Measure the SUVmax1,SUVmean1,MTV,TLG of the primary lesion,SUVmax2 and SUVmean2 of the liver.Calculate heterogeneity index-1(HI-1),heterogeneity index-2(HI-2),and tumor liver uptake ratio(TLR).Analyze the correlation between these semi quantitative parameters and clinical data characteristics of patients with postoperative chemotherapy response(TRG).Results There were statistically significant differences(P<0.05)in T stage,M stage,vascular invasion,nerve invasion,SUVmax1,SUVmean1,MTV,TLG,HI-1,HI-2,and TLR among the same TRG grading group.In multivariate analysis,SUVmax1 and SUVmean1 levels,the presence of distant metastasis,and vascular invasion were independent risk factors for predicting the efficacy of neoadjuvant chemotherapy.Conclusion The combination of ^(18)F-FDG PET/CT metabolic parameters and clinical characteristics can predict the efficacy of neoadjuvant chemotherapy in patients with gastric adenocarcinoma to a certain extent.

关 键 词：胃腺癌 ^(18)F-FDG PET/CT 异质性指数 化疗后反应 

分 类 号：R735.2[医药卫生—肿瘤] R730.44[医药卫生—临床医学]