食管癌18F-FDG PET/CT代谢参数与临床病理因素的相关性分析

The relationship between F-FDG PET/CT metabolic parameters and clinical pathologic factors of esophageal cancer

目的:探讨食管癌原发灶的18F-FDG PET/CT代谢参数与病理因素、临床分期的相关性。方法:回顾性分析82例已确诊并于术前行18F-FDG PET/CT检查的食管癌患者资料,测定食管癌原发灶的最大标准摄取值(maximum standardized uptake value,SUVmax)、代谢体积(metabolic tumor volume,MTV)及病灶糖酵解总量(total lesion glycolysis,TLG),分析各代谢参数与病理因素、临床分期的相关性,受试者工作特征(receiver operating characteristic,ROC)曲线评价各代谢参数的诊断价值。结果:82例食管癌原发灶均表现为18F-FDG高摄取。食管癌原发灶的SUVmax、MTV、TLG与患者性别、年龄及发病部位均无关(P均>0.05);SUVmax与T分期有关,MTV、TLG与病理分级、T分期、N分期、TNM分期有关(P均<0.05)。T分期与SUVmax、MTV、TLG呈正相关(P均<0.05);N分期与MTV、TLG呈正相关(P均<0.05);TNM分期与SUVmax、MTV、TLG均呈正相关(P均<0.05)。18F-FDG PET/CT代谢参数预测淋巴结转移的ROC曲线显示,MTV与TLG对淋巴结转移具有预测价值,当界值分别为28.35 cm3、89.87时诊断效率最高,灵敏度分别为60.0%、70.0%,特异度分别为71.7%、67.1%。结论:18F-FDG PET/CT代谢参数尤其是TLG及MTV,与食管癌的临床病理因素具有较好的相关性;食管癌原发灶TLG及MTV对判断淋巴结转移具有一定的参考价值。

Objective:To investigate the correlation between 18F-FDG PET/CT metabolic parameters and pathological factors or clinical stages of primary esophageal lesions.Methods:18F-FDG PET/CT image datasets of 82 patients who underwent 18F-FDG PET/CT scan before radical resection surgery were analyzed.Maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV),and total lesion glycolysis(TLG)of primary esophageal lesions were measured.The correlations of the metabolic parameters with the clinical stages and pathological factors were analyzed,and the diagnostic values of the metabolic parameters were evaluated by receiver operating characteristic(ROC)curve.Results:Primary tumors of 82 patients with esophageal cancers were characterized by high 18F-FDG uptake.There were no significant differences between metabolic parameters(SUVmax,MTV,TLG)and gender or age or tumor sites(all P>0.05).The statistically significant differences were observed between MTV or TLG and different pathologic stage(T stage,N stage or TNM stage)(all P<0.05).SUVmaxwas associated with T staging(P<0.05),but not with pathological grading,N staging or TNM(P>0.05).T staging was positively correlated with SUVmax,MTV and TLG,respectively(P<0.05).And N staging was positively correlated with MTV and TLG,respectively(P<0.05).TNM stages were positively correlated with SUVmax,MTV and TLG(all P<0.05).The ROC curve of18F-FDG PET/CT metabolism parameters for predicting lymph node metastasis showed that MTV and TLG had predictive value for lymph node metastasis.When the cutoff values were 28.35 cm3 and 89.87 respectively,the diagnostic efficiency was the highest,the sensitivities were 60.0%and 70.0%,and the specificities were 71.7%and 67.1%,respectively.Conclusion:The metabolic parameters of 18F-FDG PET/CT,especially TLG and MTV,have a good correlation with the clinicopathological factors of esophageal cancers.TLG and MTV have certain reference value for lymph node metastasis.