Prognostic value of baseline 18F-FDG PET/CT metabolic parameters combined with clinical and pathological features in surgically resected ALK-positive non-small cell lung cancer

IF 4.4 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2026-03-01 Epub Date: 2026-01-29 DOI:10.1016/j.lungcan.2026.108948

You Cheng , Jian-jiang Huang , Hao-yu Zhu , Dan Shao , Hu-bing Wu

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引用次数: 0

Abstract

Objective

To investigate the prognostic value of baseline ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET metabolic parameters, along with clinical and pathological characteristics, in predicting postoperative outcomes in patients with ALK-positive non-small cell lung cancer (NSCLC).

Methods

A retrospective analysis was conducted on patients at our institution with pathologically confirmed ALK-positive NSCLC. Baseline PET metabolic parameters, clinical characteristics, and pathological features were examined. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff values for all parameters. Survival analyses, including Kaplan–Meier curves, the log-rank test, and Cox proportional hazards regression, were employed to assess disease-free survival (DFS) and identify independent prognostic indicators.

Results

The analysis included 78 participants with a median follow-up time of 38.5 months (95% CI: 28.4 – 48.6). The median DFS was 72.8 months (95% CI: 44.7 – 100.8). Univariate analysis revealed significant associations between DFS and several clinical (T stage, overall clinical stage, and CYFRA21-1), PET (SUVmax, SUVmean, SUVpeak, TLG, and MTV), and pathological (Ki-67 index, tumor spread through air spaces [STAS], and pleural invasion) factors (p < 0.05, for all). Multivariate Cox regression analysis identified the following independent predictors of DFS: SUVmax (HR = 16.152, p = 0.002), STAS (HR = 6.122, p = 0.040), T stage (HR = 2.588, p = 0.049), and preoperative CYFRA21-1(HR = 6.509, p = 0.028).

Conclusion

The assessment of ¹⁸F-FDG PET metabolic parameters, pathological factors, and clinical characteristics provides independent prognostic information for postoperative outcomes in patients with ALK-positive NSCLC. These findings may help inform postoperative adjuvant treatment strategies.

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18F-FDG PET/CT代谢参数基线结合alk阳性非小细胞肺癌手术切除的临床和病理特征的预后价值

目的：探讨基线18f -氟脱氧葡萄糖（18F-FDG） PET代谢参数以及临床和病理特征对alk阳性非小细胞肺癌（NSCLC）患者术后预后的预测价值。方法：回顾性分析我院病理证实的alk阳性非小细胞肺癌患者。检查基线PET代谢参数、临床特征和病理特征。进行受试者工作特征（ROC）曲线分析，确定各参数的最佳截止值。生存分析，包括Kaplan-Meier曲线、log-rank检验和Cox比例风险回归，用于评估无病生存（DFS）和确定独立预后指标。结果：分析包括78名参与者，中位随访时间为38.5个月（95% CI: 28.4 - 48.6）。中位DFS为72.8个月（95% CI: 44.7 - 100.8）。单因素分析显示，DFS与多个临床（T分期、总临床分期、CYFRA21-1）、PET （SUVmax、SUVmean、SUVpeak、TLG、MTV）和病理（Ki-67指数、肿瘤通过气腔扩散[STAS]、胸膜浸润）因素存在显著相关性(p)。18F-FDG PET代谢参数、病理因素和临床特征的评估为alk阳性NSCLC患者术后结局提供了独立的预后信息。这些发现可能有助于为术后辅助治疗策略提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.