^(18)F-FDG PET/CT显像对非小细胞肺癌免疫治疗疗效预测的价值

Prognostic predictive value of ^(18)F-FDG PET/CT imaging for immunotherapy of non-small-cell lung cancer

目的探讨^(18)F-脱氧葡萄糖(fluorodeoxyglucose,FDG)PET/CT显像对非小细胞肺癌(non-small-cell lung cancer,NSCLC)免疫治疗疗效的预测价值。方法回顾性分析24例NSCLC患者免疫治疗前^(18)F-FDG PET/CT显像资料。免疫治疗6个月后按疗效评价结果将患者分为临床获益(clinical benefit,CB)组和疾病进展(progressive disease,PD)组,对患者年龄、性别、吸烟史、病理类型及PET显像参数等作单因素分析,筛选出具有统计学意义(P<0.05)的参数后,以该因素的中位数作为分组依据,采用Kaplan-Meier法绘制生存曲线,并进行log-rank生存分析。结果 CB组和PD组在年龄、性别、吸烟史和病理类型方面比较,差异均无统计学意义(均P>0.05)。在PET显像参数中,两组在全身肿瘤代谢体积(whole body lesions'metabolic tumor volume, MTV-wb)和远处转移灶代谢体积(metastatic tumors'metabolic tumor volume, MTV-mt)方面比较,差异均具有统计学意义(均P<0.05)。选取MTV-wb中位数(65.5 cm3)将患者分为MTV-wb高容积组和低容积组,选取MTVmt中位数(17.8 cm^(3))将患者分为MTV-mt高容积组和低容积组。MTV-wb高容积组和低容积组无进展生存时间(progressionfree survival,PFS)比较,差异无统计学意义[(11.8±2.2)个月vs (15.6±2.5)个月,P>0.05]。MTV-mt高容积组和低容积组PFS比较,差异无统计学意义[(13.8±3.4)个月vs (12.9±2.2)个月,P>0.05]。结论 NSCLC患者免疫治疗前^(18)F-FDG PET/CT显像对短期预后有潜在的预测价值,全身肿瘤病灶总量小的患者可能获得更好的疗效。

Objective To investigate the predictive value of ^(18) F-fluorodeoxyglucose(FDG)PET/CT imaging for immunotherapy of non-small-cell lung cancer(NSCLC).Methods The ^(18) F-FDG PET/CT imaging data of 24 NSCLC patients before immunotherapy were collected and retrospectively analyzed.According to the therapeutic response at 6 months after immunotherapy,the patients were divided into the clinical benefit(CB)group and progressive disease(PD)group.The differences of age,sex,smoking history,pathological type and PET imaging parameters of the patients were analyzed using univariate analysis.For the parameters with statistically significant differences in univariate analysis,the median were used to divided the patients into 2 groups and the survival curves were drawn.Kaplan-Meier survival analysis and log-rank analysis were performed.Results There were no significant differences in age,sex,smoking history,and pathological types between the CB and PD groups(all P>0.05).In terms of PET imaging parameters,whole body lesions’metabolic tumor volume(MTV-wb)and metastatic tumors’metabolic tumor volume(MTV-mt)were found to be significantly different(both P<0.05).Using the median of MTV-wb,65.5 cm3,and the median of MTV-mt,17.8 cm^(3),patients were divided into high and low MTV-wb groups and high and low MTV-mt groups,respectively.No significant differences were found between neither the progression-free survival(PFS)of the high and low MTV-wb groups[(11.8±2.2)months vs(15.6±2.5)months,P>0.05]nor the PFS of the high and low MTV-mt groups[(13.8±3.4)months vs(12.9±2.2)months,P>0.05].Conclusions The baseline ^(18) F-FDG PET/CT imaging before immunotherapy in NSCLC patients has a potential predictive value for short-term prognosis.Patients with small whole body tumor burden are likely to have a better prognosis.