结直肠癌^18F—FDGPET／CT代谢参数与肝转移的关系

Relationship between ^18F-FDG PET/CT metabolic parameters and fiver metastasis from colorectal cancer

目的探讨结直肠癌（CRC）原发灶18F－脱氧葡萄糖（FDG） PET/CT代谢参数与肝转移的关系。方法回顾性分析2012年1月至2016年10月间在上海市仁济医院核医学科行18F－FDG PET/CT检查的98例CRC患者资料[男66例、女32例，年龄（64±13）岁]，所有患者均在术前行PET/CT检查，检查前未行任何治疗，对CRC患者的临床病理因素以及PET/CT肿瘤代谢参数与肝转移的关系进行分析。采用χ^2=验和logistic回归分析数据。结果98例CRC患者中，无肝转移者78例，有肝转移者20例。单因素分析结果显示，无肝转移组和有肝转移组患者在肿瘤位置（χ^2=5.983）、T分期（χ^2=6.447）、血清癌胚抗原（CEA）水平（χ^2=5.501）、肿瘤代谢体积（MTV; χ^2=6.282）、病灶糖酵解总量（TLG; χ^2=9.046）上差异均有统计学意义（均P〈0.05）；多因素分析结果显示，肿瘤位置、T分期、血清CEA水平、MTV、TLG[比值比（OR）：0.059～7.575]均是CRC肝转移的独立危险因素，且MTV、TLG和肝转移呈负相关。结论CRC肿瘤位置、T分期、血清CEA水平以及原发灶PET/CT代谢参数MTV和TLG均是CRC肝转移的独立危险因素，且MTV、TLG和肝转移呈负相关。

ObjectiveTo investigate the relationship between 18F-fluorodeoxyglucose （FDG） PET/CT metabolic parameters of colorectal cancer （CRC） and liver metastasis.MethodsA total of 98 CRC patients （66 males, 32 females, average age： （64±13） years） from January 2012 to October 2016 in Shanghai Renji Hospital were enrolled in this retrospective study. All patients underwent 18F-FDG PET/CT and had not received any treatment before surgery. The relationships between clinical pathological results, metabolic parameters and liver metastasis were analyzed. Data were analyzed using χ^2=test and logistic regression analysis.ResultsPatients were divided into two groups, 78 without liver metastasis, 20 with liver metastasis. Univariate analysis showed that the tumor primary location（χ^2=5.983）, T stage（χ^2=6.447）, serum carcinoembryonic antigen （CEA） levels（χ^2=5.501）, metabolic tumor volume （MTV; χ^2=6.282） and total lesion glycolysis （TLG; χ^2=9.046） were significantly different between the two groups （all P〈0.05）. Multiple factor analysis showed that the tumor primary location, T stage, serum CEA levels, MTV and TLG （odds ratio （OR）： 0.059-7.575）were independent risk factors of CRC liver metastasis, and MTV and TLG were negatively correlated with liver metastasis.ConclusionsTumor primary location, T stage, serum CEA levels, MTV and TLG are independent risk factors of CRC liver metastasis. MTV and TLG are negatively correlated with liver metastasis.