^(18)F-FDG PET/CT代谢体积参数对Ⅱ~Ⅲ期非小细胞肺癌的预后分析

Prognosis of metabolic volume parameters by ^(18)F-FDG PET/CT in stage Ⅱ—Ⅲ non-small cell lung cancer

目的评估基于^(18)F-FDG PET/CT的肿瘤代谢体积(MTV)和糖酵解总量(TLG)对Ⅱ~Ⅲ期非小细胞肺癌(NSCLC)患者的预后价值。方法回顾性分析治疗前接受^(18)F-FDG PET/CT检查并经病理确诊的47例Ⅱ、Ⅲ期NSCLC患者的资料。采用Kaplan-Meier法、Log-rank检验及COX比例风险模型分析代谢体积参数、总生存期(OS)和无进展生存期(PFS)的关系。MTV的测量以40%最大标准化摄取值(SUV_(max))为阈值。结果所有患者中位OS为28.93个月,中位PFS为17.37个月;1年、2年、3年整体生存率分别为80.85%(38/47)、59.57%(28/47)、38.30%(18/47)。单因素分析显示SUV_(max)、MTV、TLG与OS和PFS均有关系(P均<0.05);多因素分析显示高TLG是PFS的危险因素(HR=5.591,P<0.001),高MTV是OS的危险因素(HR=4.369,P<0.001)。MTV与TNM分期存在相关性(r=0.449,P=0.012)。结论 MTV是Ⅱ、Ⅲ期NSCLC患者整体生存的独立预测因素,TLG则可预测Ⅱ、Ⅲ期NSCLC患者疾病进展。

Objective To evaluate the prognostic value of 18F-FDG PET/CT-based metabolic tumor volume（MTV）and total lesion glycolysis（TLG）in stageⅡ—Ⅲ non-small cell lung cancer（NSCLC）.Methods All of 47 patients with pathological stage on Ⅱ orⅢ NSCLC who underwent PET/CT before treatment were retrospectively reviewed.Kaplan-Meier method,Log-rank test and COXproportional hazard model were used to analyze the relationship between metabolic parameters and overall survival（OS）,progression free survival（PFS）.MTV were measured using a cutoff of 40% maximum standard uptake value（SUV（max））.Results The median OS and PFS was 28.93 and 17.37 months,and the 1-,2-and 3-year overall survival rate was 80.85%（38/47）,59.57%（28/47）,38.30%（18/47）,respectively.Univariate analysis suggested that SUV（max）,MTV and TLG had significant differences on OS and PFS（all P〈0.05）.On multivariate analysis,TLG was a risk factor for PFS（HR=5.591,P0.001）,and MTV was a risk factor for OS（HR=4.369,P0.001）.MTV was correlated with TNM-staging（r=0.449,P=0.012）.Conclusion In patients with stage Ⅱ or ⅢNSCLC,MTV is a independent significant prognostic factor for OS,and TLG is able to predict the progression.