血清癌胚抗原水平联合原发灶正电子发射计算机断层扫描代谢参数肿瘤代谢体积及病灶糖酵解总量对结直肠癌肝转移的预测价值

Predictive value of serum CEA level combined with PET/CT metabolic parameters MTV and TLG in primary liver metastases from colorectal cancer

目的分析血清癌胚抗原(CEA)水平联合原发灶正电子发射计算机断层扫描(PET/CT)代谢参数肿瘤代谢体积(MTV)及病灶糖酵解总量(TLG)对结直肠癌肝转移的预测价值.方法对2013年1月至2017年12月在浙江省人民医院行PET/CT检查的结直肠癌患者86例的临床资料进行回顾性分析,采用单因素及多因素logistic回归分析患者的临床病理参数、MTV、TLG与肝转移的关系.结果86例患者中,出现肝转移17例(19.77%).单因素分析结果发现,肝转移组T分期(χ2=8.83)、肿瘤部位(χ2=5.43)及血清CEA含量(t=11.65)与无肝转移组比较,均差异有统计学意义(均P<0.05);肝转移组TLG[(101.94±20.14)g]及MTV[(14.09±3.25)cm3]的水平较无肝转移组[(135.95±22.63)g、(25.09±4.33)cm3]明显下降(t=5.66、9.80,均P<0.01).多因素logistic回归分析结果发现,T分期(OR=3.56,95%CI:1.06~12.00)、肿瘤部位(OR=1.38,95%CI:1.05~1.81)、TLG(OR=1.68,95%CI:1.11~2.54)、MTV(OR=3.86,95%CI:1.63~9.14)及血清CEA含量(OR=2.95,95%CI:1.60~5.41)均为结直肠癌患者肝转移的影响因素(均P<0.05).结论T分期、肿瘤部位、原发灶PET/CT代谢参数(TLG、MTV)及血清CEA含量均是结直肠癌患者肝转移的影响因素,提示通过检测血清CEA水平联合原发灶PET/CT代谢参数对结直肠癌肝转移具有一定的预测价值.

Objective To analyze the predictive value of serum carcinoembryonic antigen ( CEA) level combined with primary PET/CT metabolic parameters,metabolic tumor volume( MTV) and total glycolysis( TLG) in liver metastasis of colorectal cancer.Methods The clinical data of 86 patients with colorectal cancer who underwent PET/CT examination in the People's Hospital of Zhejiang Province from January 2013 to December 2017 were retrospectively analyzed.Univariate and multivariate logistic regression was used to analyze the relationship between clinicopathological parameters,MTV, TLG and liver metastasis. Results Of the 86 patients, there were 17 cases (19.77%) of liver metastases.Univariate analysis showed that there were significant differences in T stage( χ2 =8.83),tumor location(χ2 =5.43) and serum CEA content(t=11.65) between the liver metastasis group and the non-liver metastasis group(all P<0.05).The levels of TLG[(101.94 ±20.14)g] and MTV[(14.09 ±3.25)cm3] in the liver metastasis group were significantly lower than those in the non-liver metastasis group[(135.95 ± 22.63) g, (25.09 ± 4.33)cm3] ( t=5.66,9.80,all P<0.01).Multivariate logistic regression analysis showed that T stage ( OR=3.56,95%CI:1.06-12.00),tumor location(OR=1.38,95% CI:1.05-1.81),TLG(OR=1.68,95% CI: 1.11-2.54),MTV(OR=3.86,95% CI:1.63-9.14) and serum CEA( OR=2.95,95% CI:1.60-5.41) were the influencing factors of liver metastases in patients with colorectal cancer( all P<0.05).Conclusion T stage, tumor location,primary PET/CT metabolic parameters(TLG,MTV) and serum CEA levels are the influencing factors of liver metastasis in patients with colorectal cancer,suggesting that the detection of serum CEA level combined with primary PET/CT metabolic parameters has certain predictive value for liver metastasis of colorectal cancer.