PET/CT代谢参数与LMR在评估肺癌放化疗近期疗效的临床研究

Clinical Study of PET/CT Metabolic Parameters and LMR in the Evaluation of Short-term Efficacy of Lung Cancer Chemoradiotherapy

目的研究PET/CT代谢参数与淋巴细胞/单核细胞比值(LMR)在评估肺癌放化疗近期疗效中的应用效果。方法将我院2017年1月至2018年12月间收治的32例行同步放化疗的肺癌患者纳为研究对象,分别于放化疗前、同步化疗1周期后2周(即放疗3周)进行全身PET/CT检查,放化疗结束后行胸部CT扫描;并于放化疗前24h、同步化疗1周期后2周采集空腹静脉血计算LMR,以RECIST客观疗效作为肺癌放化疗效果的“金标准”,评估PET/CT参数及LMR在肺癌放化疗近期疗效中的应用价值。结果同步化疗1周期后,32例肺癌患者SUVmax值较放化疗前下降;同步化疗1周期后,PET/CT参数提示代谢缓解率为53.13%,放化疗结束后,RECIST提示客观有效率为40.63%;以放化疗结束后RECIST客观有效率作为肺癌患者放化疗治疗效果“金标准”,同步化疗1周期后PET/CT参数在评估肺癌患者放化疗效果中的灵敏度、特异度及准确度分别为92.31%、73.68%及81.25%;代谢缓解组放化疗后LMR值较放化疗前显著降低(P<0.05),且其放化疗后LMR值显著低于无缓解组(P<0.05);RECIST客观有效组放化疗后LMR值较放化疗前显著下降(P<0.05),且其放化疗后LMR值显著低于无效组(P<0.05)。结论PET/CT参数SUVmax值及LMR值均可有效反映肺癌患者放化疗近期病灶代谢状况,在评估肺癌患者放化疗疗效中具有一定的价值。

Objective To study the application effects of PET/CT metabolic parameters and lymphocyte/monocyte ratio(LMR)in the evaluation of short-term efficacy of lung cancer chemoradiotherapy.Methods 32 patients with lung cancer who underwent concurrent chemoradiotherapy from January 2017 to December 2018 in our hospital were enrolled in the study.They were given whole-body PET/CT examination before chemoradiotherapy and at 2 weeks after 1 course of concurrent chemotherapy(that is,3 weeks of radiotherapy),and given chest CT scan after the end of chemoradiotherapy.Fasting venous blood was collected at 24h before chemoradiotherapy and at 2 weeks after 1 course of concurrent chemotherapy to calculate LMR.The objective efficacy of RECIST was used as the gold standard of lung cancer chemoradiotherapy effects to evaluate the application value of PET/CT parameters and LMR in the evaluation of short-term efficacy of lung cancer chemoradiotherapy.Results After 1 course of concurrent chemotherapy,the SUVmax value of 32 patients with lung cancer was decreased compared with that before chemoradiotherapy.After 1 course of concurrent chemotherapy,PET/CT parameters showed the metabolic remission rate was 53.13%.After the end of concurrent chemotherapy,RECIST suggested the objective effective rate was 40.63%.The objective effective rate of RECIST after the end of concurrent chemotherapy was the gold standard of chemoradiotherapy treatment effects of lung cancer patients,and the sensitivity,specificity,and accuracy of PET/CT parameters were 92.31%,73.68%,and 81.25%respectively in evaluating the chemotherapy effects of lung cancer patients after 1 course of concurrent chemotherapy.LMR value after chemoradiotherapy in the metabolic remission group was significantly lower than that before chemoradiotherapy(P<0.05),and the LMR value after chemoradiotherapy was significantly lower than that in the non-remission group(P<0.05).The LMR value after chemoradiotherapy in the RECIST objective effective group was significantly decreased compared with that before chemoradiotherapy(P<0.05),and the LMR value after chemoradiotherapy was significantly lower than that in ineffective group(P<0.05).Conclusion PET/CT parameter SUVmax value and LMR value can effectively reflect the metabolic status of recent chemoradiotherapy in patients with lung cancer,and they both have certain value in the evaluation of chemoradiotherapy efficacy of lung cancer patients.