食管癌原发灶PET/CT FDG代谢活性体积与预后相关性的分析

Correlation between FDG PET/CT metabolic activity volume and prognosis in esophageal carcinoma

目的:探讨食管癌原发灶PET/CTFDG代谢活性体积(MAV)与预后的关系。方法:收集可手术的食管鳞癌患者58例,术前行FDG-PET/CT检查,在PET图像上以SUV=2.5扣本底确定原发灶的边界,计算MAV、SUVmax及平均FDG摄取(SUVmean)与最大直径(diameter)的乘积(diameter-SUVindex)。共分为6组,A1组(n=28,MAV≤60),B1组(n=30,MAV>60),A2组(n=32,SUVmax≤8),B2组(n=26,SUVmax>8),A3组(n=35例,diameter-SUV index≤100),B3组(n=23,diameter-SUV index>100)。分别计算各组的1、2、3年生存率,同时进一步对比分析MAV、SUVmax和diameter-SUV index对预后的影响。结果:1、2和3年总生存率,A1组分别为89.3%、82.2%和64.3%,B1组分别为83.3%、70.0%和50.0%,A2组分别为92.8%、82.7%和67.9%,B2组分别为83.3%、69.3%和50.0%,A3组分别为91.5%、85.6%和71.4%,B3组分别为78.3%、60.8%和35.5%,差异均有统计学意义,P值均<0.05。多因素分析显示,di-ameter-SUV index这一指标是预测预后的独立影响因子,较其他两个指标更敏感,P<0.05。结论:食管癌原发灶代谢直径与SUVmean的乘积与患者的生存率密切相关,可评价和预测预后。

OBJECTIVE： To explore the relationship between tumor prognosis and tumor metabolic activity volume measured by 18 F-fluorodeoxyglucose PET/CT in patients with esophageal carci noma. METHODS.. Totally 58 operable patients with esophageal carcinoma were enrolled in this study. All of them had whole body 18 F-fluorodeoxyglucose PET/CT scanned before the operation. We define the boundary of primory tumor with a absolute SUV of 2.5 as segmentation threshold on PET image, and on the basis of this boundary we calculated the MAV. The patients were divided into two groups based the different MAV （Group A1, MAV 460, n= 28; Group B1, MAV〉60, n=30）, two groups based the different FDG uptake （SUVmax） of esophageal carcinoma primary lesions （Group A2, SUVmax〉8, n=32; Group B2, SUVmax〉8, n=26）, and two groups based on the ＂diameter-SUV index＂ which was calculated by multiplying the tumor diameter by the mean SUV （Group A3, diameter-SUV index≤ 100, n = 35 ; Group Ba, diame- ter-SUV index〉100, n=23）. RESULTS： The 1-,2-,3-year overall survival rate was 89.3%, 82.2%, 64.3% in the Group A1, while 83.3%,70.0%,50.0% in the Group B1, 92.8%, 82.7%, 67.9% in the Group A2, 83.3%, 69.3%, 50.0% in the Group B2, 91.5%, 85.6%, 71.4% in the Group A3, 78.3%, 60.8%, 35.5% in the Group B3, with statistical difference （P〈0.05）. In a Cox regression analysis with inclusion of MAV, SUV diameter-SUV index. The highest accuracy in predicting Prognosis was reached with the diameter-SUV index（P〈0.05）. CONCLUSION： The present study shows that the combination of diameter and SUV in the ＂diameter-SUV index＂ is valuable for predicting tumor survival and treatment response.