^(18)F-FDG PET-CT代谢参数对食管癌近期疗效预测价值研究

Short-term curative effect of ^(18)F-FDG PET-CT to chemoradiation of esophageal cancer patients

目的 ^(18)F-脱氧葡萄糖(fluorodeoxyglucose F 18,^(18)F-FDG)作为一种无创新型辅助检查,目前已经广泛运用于评估食管癌的疗效和预后。本研究旨在探讨治疗前原发灶代谢参数FDG的最大标准摄取值(maximum standardized uptake value,SUV_(max))与肿瘤代谢体积(metabolic tumor volume,MTV)在放疗或放化联合治疗的食管癌患者近期疗效预测价值。方法回顾性分析2014-01-12-2016-01-28在福建省肿瘤医院行放疗或放化联合治疗的98例食管癌患者,治疗前皆行全身^(18)F-FDG PET-CT扫描,分别分析食管原发灶SUV_(max)、MTV与年龄、性别、食管癌部位、病灶长度、分化程度、浸润深度、淋巴结转移以及临床分期等临床各因素和近期疗效的关系。结果年龄、性别、食管癌部位以及分化程度各组间SUV_(max)和MTV差异无统计学意义,P>0.05;SUV_(max)有关联的因素为病灶长度、浸润深度、淋巴结转移以及临床分期,差异有统计学意义,P<0.05;且SUV_(max)和MTV与病灶长度、浸润深度、淋巴结转移以及临床分期均呈正相关性。治疗总有效率为67.3%(66/98),有效组SUV_(max)和MTV值较无效组小,差异有统计学意义;SUV_(max)(r=-0.283,P=0.049)和MTV(r=-0.379,P=0.007)与近期疗效均呈负相关性,但MTV与近期疗效相关性较SUV_(max)更高。结论临床各因素中年龄、性别、食管癌部位以及分化程度对SUV_(max)、MTV无明显影响,但病灶长度、浸润深度、淋巴结转移以及临床分期对SUV_(max)、MTV有明显影响,疗前SUV_(max)值和MTV值均能预测放疗或放化联合治疗的食管癌患者近期疗效,但MTV较SUV_(max)预测价值更高。

OBJECTIVE As a noninvasive method, 18F_FDG PET-CT has been widely used in evaluating the thera- peutic results and predicting the prognosis of esophageal cancer. The purpose of the study was to evaluate whether the SUVmax and MTV predict short-term clinical curative effect of radiotherapy or chemoradiotherapy in nonoperative esopha- geal squamous cell cancer. METHODS A retrospective analysis was made on 98 cases patients with esophageal cancer from January 12, 2014 to January 28, 2016 in Fujian Provincial Cancer Hospital. All of them had examinations by 18 FDG PET-CT before treatment. Respective analysis was conducted on SUV MTVmas relationship with clinical factors and short-term clinical curative effect. RESULTS There was no difference on SUVmax and MTV of different group of age, gender, morbid position and histologically differentiated degree（P〈0.05）. Positive correlation was found between the SUV MTV and lesion length,T grade, stage pathologic N stage and clinical stage. The effective rate was 67.3 - （66/98）. The effective group was lower than ineffective group in the SUVmax and MTV and it was negative correlation between SUVmax （r=-0. 283, P=0. 049）, MTV（r=--0. 379, P=0. 007） and short-term curative effect, but the correlation ofMTV was stronger than SUV CONCLUSIONS There is no significant effect on SUV and MTV for age,gender, morbid position and histologically differentiated degree （P〈0.05）, but lesion length, T grade, pathologic N stage and clinical stage are significantly positivly correlated with SUVmax and MTV. The SUVmax and MTV can predict short-term clinical curative effect of radiotherapy or chemoradiotherapy in nonoperative esophageal squamous cell cancer, but MTV was more valuable than SUVmax.