18F-FDG PET/CT显像最大标准化摄取值(SUVmax)与肺腺癌及其亚型EGFR突变的相关性

Correlation between F-FDG PET/CT maximum standardized uptake value and epidermal growth factor receptor mutation status in pulmonary adenocarcinoma and its different histologic subtypes

目的探讨18F-FDG PET/CT显像最大标准化摄取值(18F-FDG maximum standardized uptake value,SUVmax)与肺腺癌及其不同组织学亚型表皮生长因子受体(epidermal growth factor receptor,EGFR)突变之间的相关性。方法回顾性分析305例经病理证实为肺腺癌患者的PET/CT图像与临床病理学资料,包括年龄、最大径、性别、吸烟史、是否转移、分期、组织学亚型及分化程度。通过单因素和多因素Logistic回归分析方法,得出纳入分析的变量中与EGFR突变相关的因素,并制作计分量表预测EGFR突变状态。结果EGFR整体突变率为63.6%(194/305),EGFR突变与女性(72.9%vs.54.0%,P=0.001)、不吸烟(68.2%vs.46.0%,P=0.001)、SUVmax≤5.5(75.2%vs.57.1%,P=0.006)及中低危分组(67.4%,65.2%vs.44.9%,P=0.012)显著相关。计分量表得分与EGFR突变显著相关(P<0.001),ROC定义得分>2为最佳截断值,敏感度、特异度及准确度分别为64.4%、59.6%及62.6%。结论PET/CT对EGFR突变有一定的预测价值,接合患者的临床病理资料和SUVmax,则预测价值更高。

Objective To investigate the relationship between18 F-FDG maximum standardized uptake value(SUVmax)and epidermal growth factor receptor(EGFR)mutation in pulmonary adenocarcinoma and its different histologic subtypes.Methods The PET/CT imaging and clinicopathological data of 305 patients with lung adenocarcinoma confirmed by pathology were retrospectively analyzed.Clinicopathological data included age,diameter,gender,smoking status,metastasis,stage,pathological subtypes and differentiate grade.The factors related to EGFR mutation were analyzed by univariate and multivariate Logistic regression analysis.The scoring scale was made to predict EGFR mutation status.Results The overall mutation rate of EGFR was 63.6%(194/305).EGFR mutation was significantly correlated with women(72.9%vs.54.0%,P=0.001),non-smoking(68.2%vs.46.0%,P=0.001),SUVmax≤5.5(75.2%vs.57.1%,P=0.006),and low and medium risk groups(67.4%,65.2%vs.44.9%,P=0.012).The score of the scoring scale was significantly correlated with EGFR mutation(P<0.001),and the score>2 was defined as the optimal cut-off value of the ROC curvewith sensitivity of 64.4%,specificity of 59.6%and accuracy of 62.6%.Conclusion PET/CT has certain predictive value for EGFR mutation,and its predictive value is higher by combining clinic opathological data of patients with SUVmax.