非小细胞肺癌患者^(18)F-FDG PET/CT代谢参数与靶向或化疗疗效及预后的关系

Relationship between ^(18)F-FDG PET/CT metabolic parameters and efficacy of targeted therapy or chemotherapy and prognosis in patients with non-small cell lung cancer

目的研究非小细胞肺癌(NSCLC)患者18氟代脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层显像(PET/CT)代谢参数与靶向或化疗疗效及预后的关系。方法回顾性分析2019年1月~2020年4月我院病理确诊并进行靶向治疗或化疗的64例NSCLC患者的临床资料,收集患者的^(18)F-FDG PET/CT代谢参数,包括最大标准摄取值(SUV_(max))、肿瘤代谢体积(MTV),并采用Kaplan-Meier法、Log-Rank检验及多因素Cox回归分析上述参数与患者无进展生存时间(PFS)和总生存时间(OS)的关系。结果单因素分析显示,胸腔积液、病灶数目、TNM分期、病灶最大直径、治疗方式、MTV参数是患者PFS及OS的影响因素(P<0.05),SUV_(max)仅是患者PFS的影响因素(P<0.05);Kaplan-Meier生存分析显示,代谢参数SUV_(max)≤12.56的患者PFS高于SUV_(max)>12.56的患者(P<0.05),MTV≤28.03 cm3的患者PFS和OS均高于MTV>28.03 cm3的患者(P<0.05)。Cox多因素分析显示,参数MTV是影响患者PFS及OS的危险因素(P<0.05)。结论MTV是影响患者PFS和OS的相关因素,^(18)F-FDG PET/CT代谢参数对NSCLC患者的预后判断有一定的价值。

Objective To study the relationship of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)metabolic parameters with efficacy of targeted therapy or chemotherapy and prognosis in patients with non-small cell lung cancer(NSCLC).Methods The clinical data of 64 patients with NSCLC who were confirmed by pathology and received targeted therapy or chemotherapy in the hospital were retrospectively analyzed from January 2019 to April 2020.The ^(18)F-FDG PET/CT metabolic parameters of the patients were collected,including the maximum standard uptake value(SUV_(max))and metabolic tumor volume(MTV).Kaplan-Meier method,Log-Rank test and multivariate Cox regression analysis were used to analyze the relationship between the above parameters and progression-free survival(PFS)and overall survival(OS).Results Univariate analysis showed that pleural effusion,number of lesions,TNM staging,maximum diameter of lesions,treatment methods and MTV parameters were the influencing factors of PFS and OS(P<0.05),and SUV_(max) was the only influencing factor of PFS(P<0.05).Kaplan-Meier survival analysis showed that the PFS of patients with metabolic parameter SUV_(max)≤12.56 was higher than that of patients with SUV_(max)>12.56(P<0.05),and the PFS and OS of patients with MTV≤28.03 cm 3 were higher than those of patients with MTV>28.03 cm 3(P<0.05).Cox multivariate analysis showed that the parameter MTV was a risk factor affecting PFS and OS(P<0.05).Conclusion MTV is a related factor affecting the PFS and OS of patients.Metabolic parameters of ^(18)F-FDG PET/CT are of certain value for the prognosis of patients with NSCLC.