^(18)FDG-PET预测非小细胞肺癌化疗的最佳客观疗效

Prediction of best objective response to chemotherapy in non-small cell lung cancer by ^(18)FDG-PET

目的前瞻性地探索18-氟脱氧葡萄糖-正电子发射计算机断层扫描(18FDG-PET)的早期代谢疗效与RECIST标准评价的非小细胞肺癌(NSCLC)化疗最佳客观疗效的关系。方法初治不可切除的局部晚期和晚期NSCLC患者前瞻性入组,行含铂双药方案全身化疗。按RECIST标准和SUV值标准(2周期化疗后SUV值下降>30%)互为盲法分别评价肿瘤客观疗效。用配对计数资料的χ2检验和κ系数检验比较2周期后18FDG-PET代谢缓解与RECIST标准的最佳客观疗效是否具有一致性(SPSS13.0)。结果不可切除的局部晚期9例,晚期46例。18FDG-PET代谢缓解与按RECIST标准评价的最佳客观疗效具有明显的一致性(P<0.001)。18FDG-PET预测NSCLC化疗最佳客观疗效的敏感性、特异性、准确性、阳性预测值和阴性预测值分别是95%、67%、78%、66%和96%。结论18FDG-PET可以预测局部晚期和晚期NSCLC化疗的最佳客观疗效。

Objective To prospectively evaluate the use of positron emission tomography （PET）with the glucose analog 18-fluorodeoxyglucose （18 FDG）to assess best objective response after chemotherapy in patients with unresectable locally advanced or advanced non-small cell lung cancer（ NSCLC）. Methods Patients with unresectable locally advanced or advanced NSCLC were prospectively enrolled into this study to undergo platinum-based doublet chemotherapy. Patients were studied by 18↑ FDG-PET before and after the first two cycles of chemotherapy. A reduction of tumor is FDG uptake by more than 30% as assessed by standardized uptake value （SUV）was used as a criterion for a metabolic response. Compare RECIST best objective response with 18↑ FDG-PET metabolic response by the way of X^2 test and κ test （SPSS13.0）. Results 55 patients （9 with unresectable locally advanced NSCLC and 46 with advanced NSCLC）were included in the study. There was a close correlation between metabolic response and best objective response to chemotherapy according to RECIST,P 〈 0. 001 ; Sensitivity, specificity, accuracy, prediction of positive value and prediction of negative value were 95 % , 67% ,78% ,66% and 96% respectively. Conclusion 18↑FDG-PET may predict best objective response to chemotherapy for NSCLC patients.