基线^(18)F-FDG PET/CT参数与临床参数对宫颈鳞状细胞癌预后的预测价值

Prognostic value of metabolic parameters on ^(18)F-FDG PET/CT imaging and clinical features in patients with squamous cell carcinoma of the cervix

目的评估^(18)F-FDG PET/CT代谢参数与临床相关参数对宫颈鳞状细胞癌(简称鳞癌)患者预后的影响。方法回顾性收集青岛大学附属医院2011年5月至2020年12月行基线^(18)F-FDG PET/CT检查的宫颈鳞癌患者174例[年龄(53.6±11.1)岁]。收集宫颈癌病变的代谢参数[原发肿瘤代谢体积(MTV_(p))、原发病灶糖酵解总量(TLG_(p))、全身病灶的MTV之和(MTV_(total))、全身病灶的TLG之和(TLG_(total))]及临床参数[国际妇产科联盟(FIGO)分期、肿瘤最大径(Dmax)等],并通过Cox回归、Kaplan-Meier法分析各参数对于宫颈癌的预后价值。结果随访6~120个月,共52例患者疾病进展,占29.9%(52/174)。患者的5年总生存(OS)率、无进展生存(PFS)率、局部控制(LC)率、无远处转移生存(DMFS)率分别为83.3%(145/174)、70.1%(122/174)、75.3%(131/174)、82.8%(144/174)。Cox回归分析示FIGO分期、MTV_(total)为PFS、OS、LC的预测因素[风险比(HR):1.005~11.605,均P<0.05]。FIGO分期、TLG_(total)为DMFS的预测因素(HR:1.002~12.258,均P<0.05)。结论 MTV_(total)、FIGO分期是预测宫颈鳞癌患者预后的影响因素。

ObjectiveTo estimate the influence of metabolic parameters in ^(18)F-FDG PET/CT and clinically relevant indicators on the prognosis of patients with cervical cancer.MethodsA total of 174 patients with cervical cancer(age(53.6±11.1)years)who underwent baseline ^(18)F-FDG PET/CT examination in the Affiliated Hospital of Qingdao University from May 2011 to December 2020 were retrospectively collected.Metabolic parameters(metabolic tumor volume of primary lesion(MTV_(p)),total lesion glycolysis of primary lesion(TLG_(p)),MTV sum of total lesions(MTV_(total))in the whole body,TLG sum of total lesions(TLG_(total)))and clinical parameters(International Federation of Gynecology and Obstetrics(FIGO)stage,tumor maximum diameter(D max),et al)were collected.Cox regression and Kaplan-Meier method were performed to evaluate the prognostic and predictive values of those parameters.ResultsThe follow-up time was 6-120 months,during which 52 patients(29.9%,52/174)developed progression.The 5-year overall survival(OS),progression-free survival(PFS),local control(LC)and distant metastasis-free survival(DMFS)rates were 83.3%(145/174),70.1%(122/174),75.3%(131/174)and 82.8%(144/174),respectively.Cox regression showed that FIGO stage and MTV_(total) were independent factors for predicting PFS,OS and LC(hazard ratio(HR):1.005-11.605,all P<0.05).FIGO stage and TLG_(total) were independent factors for predicting DMFS(HR:1.002-12.258,all P<0.05).ConclusionMTV_(total) and FIGO stage are effective predictors of patients with cervical squamous cell carcinoma.