非小细胞肺癌淋巴结转移与肿瘤原发灶最大径及^(18)F-FDG PET/CT代谢参数的相关性

Correlation Between Lymph Node Metastasis with Maximum Diameter of Primary Lesion and Metabolic Parameters of ^(18)F-FDG PET/CT in Non-small Cell Lung Cancer

目的探讨非小细胞肺癌(NSCLC)原发灶最大径和代谢参数与淋巴结转移的关系。资料与方法回顾性分析2015年12月—2018年1月于南京中医药大学沭阳附属医院行^(18)F-脱氧葡萄糖(^(18)F-FDG)PET/CT检查且初诊为NSCLC的87例患者肿瘤原发灶的最大径、最大标准化摄取值(SUVmax)、平均标准化摄取值(SUVmean)、代谢体积(MTV)和病灶糖酵解总量(TLG),根据肿瘤原发灶最大径分为结节组(28例)和肿块组(59例),分析各参数与淋巴结转移的相关性;根据原发灶最大径和SUVmax的界值将患者分为低危组(21例)、中危组(33例)和高危组(33例),分析各组淋巴结转移的差异。结果 87例NSCLC患者原发灶代谢参数SUVmax、SUVmean、MTV、TLG分别为9.13±5.12、5.26±2.88、12.56(4.98,29.41)cm3、76.53(16.20,211.20)g。结节组和肿块组肿瘤原发灶最大径与代谢参数SUVmax、SUVmean、MTV、TLG差异均有统计学意义(P<0.001),肿瘤原发灶最大径与SUVmax、SUVmean、MTV、TLG呈正相关(r=0.640、0.636、0.749、0.789,P均<0.05)。原发灶的最大径与肿瘤N分期呈正相关(r=0.368,P<0.05);SUVmax、SUVmean与肿瘤N分期呈正相关(r=0.335、0.331,P<0.05)。低危组、中危组、高危组淋巴结转移发生率分别为33.3%(7/21)、72.7%(24/33)和87.9%(29/33),差异有统计学意义(x^2=18.19,P<0.05)。结论 NSCLC肿瘤原发灶SUVmax和最大径与淋巴结转移有关,SUVmax联合肿瘤原发灶最大径可以预测肿瘤淋巴结转移风险。

Purpose To investigate the correlation between the maximum diameter of primary lesion and metabolic parameters with lymph node metastasis in non-small cell lung cancer (NSCLC). Materials and Methods The maximum diameter o f primary lesion, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of 87 NSCLC patients who received 18F-fluorodeoxyglucose (18F-FDG) PET/CT examination in Shuyang Affiliated Hospital of Nanjing University o f Chinese Medicine from December 2015 to January 2018 were retrospectively analyzed. The patients were assigned into nodule group (28 cases) and mass group (59 cases) according to the maximum diameter of primary lesion, and the correlation of each parameter and lymph node metastasis was analyzed;the patients were further assigned into low-risk group (21 cases), moderate-risk group (33 cases), and high-risk group (33 cases) based on the maximum diameter of primary lesion and SUVmax, and the difference in lymph node metastasis among the three groups were analyzed. Results SUVmax, SUVmean, MTV and TLG, the metabolic parameters o f primary lesion, were respectively 9.13±5.12, 5.26±2.88, 12.56 (4.98, 29.41) cm3 and 76.53 (16.20, 211.20) g. The maximum diameter of primary lesion was in positive correlation with SUVmax, SUVmean, MTV and TLG (r=0.640, 0.636, 0.749 and 0.789, respectively, all P<0.001), with statistically significant differences between nodule group and mass group (all P<0.05). The maximum diameter of primary lesion, SUVmax and SUVmean were in moderately positive correlation with the N stage of primary lesion (r=0.368, 0.335 and 0.331, respectively, all P<0.05). The incidence of lymph node metastasis was respectively 33.3%(7/21), 72.7%(24/33) and 87.9%(29/33) in low-risk group, moderate-risk group and high-risk group, with statistical significance (χ^2=18.19, P<0.05). Conclusion The maximum diameter of primary lesion and SUVmax are related to lymph node metastasis. The risk o f lymph node metastasis can be predicted by combining SUVmax and the maximum diameter of primary lesion in NSCLC.