原发性肺癌^(18)F-FDG PET/CT代谢参数与其临床病理特征的关系

Relationships of lung cancer ^(18)F-FDG PET/CT metabolic parameters and clinicopathological features

目的探讨原发性肺癌^(18) F-FDG PET/CT代谢参数与其临床病理特征的关系。方法回顾性收集经PET/CT及手术、经皮穿刺肺活检或纤维支气管镜组织病理检查证实的159例原发性肺癌患者,分别根据患者年龄、性别,原发灶位置、最大径、T分期、N分期及M分期进行分组,比较组间PET/CT及临床特征,分析其相关性。利用受试者工作特征(ROC)曲线分析肿瘤原发灶最大径、代谢参数与淋巴结转移的关系,以曲线下面积(AUC)评价其诊断效能。结果组间比较,患者性别、原发灶大小、T分期、N分期、组织病理类型及肿瘤各代谢参数差异均有统计学意义(P均<0.05);肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)与M分期差异均有统计学意义(P均<0.05)。最大标准摄取值(SUV max)、瘦体重标准化SUV max(SUL max)、MTV及TLG均与肿瘤原发灶最大径、T分期呈正相关(P均<0.05),与N分期均无明显相关(P均>0.05);MTV、TLG均与肿瘤M分期呈正相关(P均<0.05)。联合肿瘤原发灶最大径和SUV max可预估淋巴结转移风险。结论PET/CT所示肺癌SUV max、SUL max、MTV及TLG与其临床病理特征存在一定关系;联合应用原发灶最大径及SUV max可预测淋巴结转移风险。

Objective To explore the relationships of lung cancer ^(18)F-FDG PET/CT metabolic parameters and clinicopathological factors.Methods A total of 159 patients with lung cancer confirmed pathology who underwent PET/CT examination were collected.The patients were classified into different groups according to patients'age,sex,the location,the maximum diameter and the T,N,M stage of primary tumors,respectively.PET/CT manifestations and clinical data were compared,and the correlations of metabolic parameters and clinicopathological data were analyzed.The relationships of the maximum diameter of primary tumor,metabolic parameters and lymph node metastasis were analyzed with receiver operating characteristic(ROC)curve,and the diagnostic efficacy was evaluated according to the area under the curve(AUC).Results There were significant differences of patient gender,primary tumor size,metabolic parameters and T stage,N stage and histopathological types of lung cancers(all P<0.05),also of tumor metabolic volume(MTV),total lesion glycolysis(TLG)and M stage(all P<0.05).The maximum standard uptake value(SUV_(max)),SUV_(max) normalized by lean body mass(SUL_(max)),MTV and TLG were positively correlated with the maximum diameter and T stage of primary tumor(all P<0.05),but not with tumor N stage(all P>0.05).MTV and TLG were positively correlated with tumor M stage(both P<0.05).Combining the maximum diameter of primary tumor and SUV_(max) could predict the risk of lymph node metastasis.Conclusion SUV_(max),SUL_(max),MTV and TLG had certain relationships with clinicopathological features of lung cancer.Combining the maximum diameter of primary tumor and SUV_(max) could predict the risk of lymph node metastasis of lung cancer.