18^F—FDGPET—CT最大标准化摄取值与非小细胞肺癌临床病理特征的关系

Relationship between maximum standardized uptake values of 18^F-FDG PET-CT and clinicopathological characteristics in non-small cell lung cancer

目的探讨非小细胞肺癌（NSCLC）的18^F-FDGPET-CT最大标准化摄取值（SUVmax）与临床病理特征的关系。方法回顾性分析105例术前行PET—CT检查的NSCLC患者，对可能影响肿瘤SUVmax的因素，包括性别、年龄、吸烟史、癌胚抗原、肿瘤位置、组织学类型、TNM分期、T分期、N分期、肿瘤大小、脉管浸润和胸膜浸润进行单因素分析和多元回归分析。通过受试者工作特征曲线分析suVmax的诊断效率和最佳诊断界值。结果单因素分析提示suvmax与癌胚抗原（P=0．002）、肿瘤大小（P〈0．001）、组织学类型（P〈0．001）、TNM分期（P〈0．001）、T分期（P〈0．001）、N分期（P〈0．001）、脉管浸润状态（P=0．001）有关；多元线性回归分析显示组织学类型（P=0．004）、肿瘤大小（P=0．036）、N分期（P=0．043）是肿瘤SUVmax的独立影响因素。肿瘤SUVmax对淋巴结转移有预测价值，以6．75为界值时诊断效率最高，敏感度为72．2％，特异度为81．6％。结论NSCLC的18^F-FDGPET-CT与组织学类型、肿瘤大小、淋巴结转移情况相关，非腺癌、肿瘤较大、伴有淋巴结转移者SUVmax较高，肿瘤SUVmax可预测淋巴结转移风险。

Objective To analyze the correlation of clinicopathological characteristics and maximum standardized uptake value （SUVmax） detected by 18^F-FDG PET-CT in non-small cell lung cancer （NSCLC）. Methods 105 patients with NSCLC who underwent 18^F-FDG PET-CT scan before surgical resection were reviewed retrospectively. Clinicopathological factors which might affect SUVmax were evaluated, including sex, age, smoking history, CEA level, tumor site, histological type, TNM stage, T factor, N factor, tumor size, lymphovascular invasion and pleural invasion features. Independent factors were identified by multiple regression analysis. The diagnostic efficiency and best cut-off point of SUVmax were calculated by the receiver operating characteristic curve. Results It was identified by the univariate analysis that the CEA level （P = 0.002）, tumor size （P 〈 0.001）, histological type （P 〈 0.001）, TNM stage （P 〈 0.001）, T factor （P 〈 0.001）, N factor （P 〈 0.001）, and lymphovascular invasion （P = 0.001） were factors affecting SUVmax. While histological type （P = 0.004）, tumor size （P = 0.036）, N factor （P = 0.043） were found to be significant independent factors according to multivariate regression analysis. The SUVmax of primary tumor was a predictor for lymphatic metastasis with the highest diagnostic accuracy at a cut-off value of 6.75, the sensitivity and specificity were 72.2 % and 81.6 %, respectively. Conclusions The SUVmax is correlated with histological type, tumor diameter, nodal status in NSCLC, and is higher in patients with non- adenocarcinoma, lager tumor and lymphatic metastasis. Furthermore, the probability of lymphatic metastasis could be predicted by SUVmax of the primary tumor.