^(18)F-FDG PET/CT代谢参数与局部进展期宫颈癌疾病进展的关系

Metabolic parameters on^(18)F-FDG PET/CT to predict disease progression in locally advanced cervical cancer

目的探讨^(18)F标记氟代脱氧葡萄糖(^(18)F-FDG)正电子发射断层/计算机断层扫描(PET/CT)代谢参数与局部进展期宫颈癌(LACC)同步放化疗后疾病进展的关系。方法纳入267例在治疗前行^(18)F-FDGPET/CT显像的LACC患者,分析患者临床病理特征与疾病进展的关系;测量/计算宫颈癌原发灶最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))、峰值标准摄取值(SUV_(peak))、肿瘤代谢体积(MTV)和病灶糖酵解总量(TLG),绘制ROC曲线,分析这些代谢参数与疾病进展的关系。采用Cox比例风险回归模型对各项可能的预后因素进行单因素和多因素分析。结果所有患者中位随访时间36.52(24.52,41.11)个月,随访期间80例(30.0%)患者出现病情进展。单因素分析显示,国际妇产科联盟(FIGO)分期、原发灶MTV和TLG与疾病进展显著相关(均P<0.05)。多因素Cox回归分析显示,FIGO分期ⅢA~Ⅳ期(HR=1.71,95%CI:1.04~2.81,P<0.05)和MTV≥29.39(HR=1.99,95%CI:1.28~3.11,P<0.01)是LACC疾病进展的独立预测因子。结论^(18)F-FDGPET/CT代谢参数与同步放化疗后LACC患者疾病进展相关,结合临床病理特征可有望为个体化治疗提供帮助。

Objective The present study investigated the predictive diseases progression value of preoperative fluorodeoxyglucose(FDG)positron emission tomography/computed tomography(PET/CT)in patients with local advanced cervical cancer(LACC).Methods In total,267 patients with LACC underwent^(18)F-FDG PET/CT prior to any treatment.The maximum standardized uptake value(SUV_(max)),mean standardized uptake value(SUVmean),peak standardized uptake volume(SUV_(peak)),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)of the primary lesion were measured on PET/CT and correlated with clinicopathological features and progression-free survival(PFS).Results The median follow-up was 36.52(24.52,41.11)months.During the observation period,80(30.0%)patients exhibited disease progression.Univariate analysis showed that FIGO stage,primary tumor MTV and TLG were significantly associated with disease progression(all P<0.05,respectively).FIGO stagingⅢAⅣA(HR=1.71,95%CI:1.04-2.81,P<0.05)and MTV≥29.39(HR=1.99,95%CI:1.28-3.11,P<0.01)were independent risk factor for PFS.Conclusion Pretreatment cervical metabolic parameters on^(18)F-FDG PET/CT were associated with PFS in patients with LACC,thus partly providing help for individualized treatment.