^(18)F-FDG PET/CT 代谢参数对Ⅲ~Ⅳ期卵巢癌患者预后的预测价值

Predictive Value of ^(18)F-FDG PET/CT Metabolic Parameters for Prognosis of Patients with Stage Ⅲ-Ⅳ Ovarian Cancer

目的探讨18-氟代脱氧葡萄糖(^(18)F-FDG)正电子发射断层成像/计算机断层扫描(PET/CT)在卵巢癌(OC)中的应用价值,并对患者的预后情况进行分析。方法回顾性分析经病理活检证实的OC且采用双盲法对OC进行分期,分期为Ⅲ~Ⅳ期的OC患者48例,其中Ⅲ期23例,Ⅳ期25例。SUVmax、肿瘤代谢体积(MTV)、糖酵解总量(TLG)的最佳界值通过受试者工作特征(ROC)曲线确定;使用Kaplan-Meier法及Log-rank检验分析影响生存时间的单因素;多因素分析则采用Cox比例风险模型。结果Ⅲ~Ⅳ期OC患者经PET/CT扫描后测量SUVmax、MTV、TLG的最佳界值分别为8.8、172.25、1438.4。单因素分析显示,SUVmax、MTV、TLG均与总生存时间(OS)有关(P值均<0.05),且均与OS呈负相关;多因素分析显示,SUVmax是OS的独立预后因素(P值均<0.05)。Ⅲ期OC患者,SUVmax、MTV、TLG均与OS呈负相关(P值均<0.05),多因素分析显示,高SUVmax为OS的独立危险因素(P=0.03);Ⅳ期OC患者,仅SUVmax能预测OS,且呈负相关(P=0.03)。结论 SUVmax、MTV、TLG都可以预测Ⅲ~Ⅳ期卵巢癌的生存时间;SUVmax可以作为OS的独立预测因子。

Objective To analyze the value of ^(18)F-fluorodeoxyglucose-positron emission tomography/computed tomography(^(18)F-FDG PET/CT) in ovarian cancer, and to evaluate the prognosis of patients. Methods A total of 48 patients with ovarian cancer which had been proved by pathological biopsy were collected from December 2014 to January 2021 in the Affiliated Hospital of Southwest Medical University retrospectively.There were 23 cases of stage Ⅲ and 25 cases of stage Ⅳ.Each patient was staged with double-blind method.Stages Ⅲ to Ⅳ were selected.The optimal bounds of SUVmax, tumor metabolic volume(MTV) and total glycolysis(TLG) were determined by receiver operating curve(ROC).Kaplan-Meier method and Log-rank test were used to analyze the single factor affecting survival time.Cox proportional risk model was used for multivariate analysis. Results The optimal bounds of SUVmax, MTV,and TLG by PET/CT scanning in patients with stage Ⅲ-Ⅳ OC were 8.8,172.25,and 1438.4,respectively.Univariate analysis showed that SUVmax, MTV and TLG were all correlated with OS(P<0.05),and were negatively correlated with OS.Multivariate analysis showed that SUVmax was an independent prognostic factor for OS(all P<0.05).In patients with stage Ⅲ OC,SUVmax, MTV and TLG were negatively correlated with OS(all P<0.05).Multivariateanalysis showed that high SUVmax was an independent risk factor for OS(P=0.03).In patients with stage Ⅳ OC,only SUVmax predicted OS with a negative correlation(P=0.03). Conclusion SUVmax, MTV,and TLG all predicted survival time for stage Ⅲ-Ⅳ ovarian cancer.SUVmax can be used as an independent predictor of OS.