^(18)F-FDG PET/CT对Ia期肺癌患者复发预测的初步研究

Preliminary Study of Predicting Recurrence of Stage Ia Lung Cancer with ^(18)F-FDG PET/CT

目的:探讨18F-FDG PET/CT显像对Ia期肺癌患者复发预测的价值。方法:收集2005年1月至2009年4月在本PET/CT中心检查的肺孤立性结节患者259例,经手术证实为Ia期肺癌患者70例,失访28例,42例纳入研究。随访2年以上明确复发者13例,无复发者29例。将性别、年龄、病灶大小、平均SUV值、最大SUV值及病理类型纳入研究变量行单因素生存分析及Cox比例风险模型多因素分析。结果:单因素分析显示:最大SUV<5.0组及>5.0组的平均复发时间分别为66.98m、45.29m(P=0.01),年龄、性别、病灶大小、平均SUV不同分组的平均复发时间差别无统计学差异(P<0.05)。多因素分析显示:最大SUV值是影响Ia期肺癌复发的重要因素(P=0.02),最大SUV值每升高"1",患者复发风险升高15.5%。结论:18F-FDG PET/CT所提供的病灶最大SUV值对Ia期肺癌患者复发具有一定的预测价值。

Purpose： To study the prognostic value of 18F-FDG PET/CT in patients with completely resected stage IA lung caner. Methods： Two hundreds and fifty-nine patients with solitary pulmonary nodule from Jan 2005 to Apr 2009 were collected in our PET/CT center. Among these patients, 70 patients were diagnosed as stage Ia lung cancer according to the post-surgical pathology. Of these 70 patients, 42 were included in our study and 28 patients were excluded because of losing follow-up. Thirteen patients had tumor recurrence and 29 patients had no recurrence according to more than 2 years＇ follow-up. Six prognostic factors including age, sex, lesion size, average SUV, maximal SUV and pathological type were selected as the research variables. Kaplan-Meier survival analysis method was used for the univariate analysis. Differences in observed survival between groups were tested for significance using the log rank test. Cox regression method was used for the multivariate analysis. Results： The univariate analysis identified that the average time of recurrence was 66.98m for the patients with maximal SUV〉5.0 and 45.29m for the patients with maximal SUV〈5.0 （P=0.01）. Other factors including age, sex, lesion size and average SUV were not related to the prognosis of stage Ia lung cancer （P〈0.05）. Cox regression analysis showed that maximal SUV was important prognostic factor for predicting recurrence （P=0.02）. A oneunit increase of maximal SUV corresponded with a 15.5% increase of risk of recurrence. Conclusion： The maximal SUV from 18F-FDG PET/CT was related with the time of recurrence and had high clinical value for predicting the recurrence of stage Ia lung cancer.