18F-FDG PET/CT代谢体积参数对中晚期NSCLC患者预后的预测价值

Predictive Value of 18F-FDG PET/CT Metabolic Volume Parameters for Prognosis of Patients with Medium and Advanced NSCLC

目的分析18氟代脱氧葡萄糖(18F-FDG)正电子发射计算机断层显像(PET/CT)代谢体积参数对中晚期NSCLC患者预后的预测价值。方法回顾性分析2016年1月至2018年1月四川友谊医院接受18F-FDG PET/CT检查并经病理确诊的中晚期NS CLC患者8 2例的临床资料,应用Kaplan-Meier法、Log-rank检验及COX比例风险模型分析18F-FDG PET/CT的代谢体积参数[肿瘤最大直径、SUVmax、肿瘤代谢体积(MTV,以40%最大标准化摄取值SUVmax为阈值)、糖酵解总量(TLG)]与总生存期(OS)、无进展生存期(PFS)的关系。结果 82例NSCLC患者肿瘤最大直径、SUVmax、MTV、TLG的中位数及范围分别为3.42 (1.5~13.57)cm、1 4.26(5.27~33.78)cm2、17.69(2.16~134.84)、143.89 (6.48~2741.35);所有患者整体中位OS为21.78个月,中位PFS为17.14个月,不同肿瘤最大直径、是否手术、TNM分期、MTV、TLG患者的OS、PFS差异均有统计学意义(P<0.05);多因素分析显示,高MTV为OS的危险因素,高TLG为PFS的独立危险因素(P<0.05)。结论18F-FDG PET/CT代谢体积参数对中晚期NSCLC患者预后有较高预测价值,值得在临床推广实践。

Objective To analyze the predictive value of 18F-fluorodexyglucose(18FFDG) positron emission tomography/computed tomography(PET/CT) metabolic volume parameters for prognosis of patients with medium and advanced non-small cell lung cancer(NSCLC).Methods The clinical data of 82 patients confirmed with medium and advanced NSCLC by pathology who underwent 18F-FDG PET/CT in Sichuan Friendship Hospital from January 2016 to January 2018 were retrospectively analyzed.Kaplan-Meier method,Log-rank test and COX proportional hazard model was performed to analyze the relationship between metabolic volume parameters of 18FFDG PET/CT [maximum tumor diameter,SUVmax,metabolic tumor volume(MTV,taking 40% maximum normalized uptake value SUVmax as threshold),total lesion glycolysis(TLG)] and overall survival(OS),progression-free survival(PFS).Results In the NSCLC82 patients,median and range of tumor maximum diameter,SUVmax,MTV and TLG were 3.42(1.5~13.57) cm,14.26(5.27~33.78) cm2,17.69(2.16~134.84) and 143.89(6.48~2741.35),respectively.The overall median OS and median PFS of all patients were 21.78 months and 17.14 months,respectively.There were significant differences in OS and PFS of patients with different maximum tumor diameter,undergoing surgery or not,TNM stage,MTV and TLG(P<0.05).Multivariate analysis showed high MTV was a risk factor for OS,and high TLG was an independent risk factor for PFS(P<0.05).Conclusion The 18F-FDG PET/CT metabolic volume parameter are of relatively higher predictive value for prognosis of patients with medium and advanced NSCLC.