{"title":"18F-FDG-PET-CT代谢参数在评估鼻咽癌原发肿瘤侵袭性和淋巴结转移中的实用性","authors":"Yun Zhang, Yuxiao Hu, Shuang Zhao, Rong Huang","doi":"10.1177/11795549231225419","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Following changes in primary tumor (T) and lymph node (N) staging for nasopharyngeal carcinoma (NPC) in the <i>Eighth Edition AJCC Cancer Staging Manual</i>, simplification of T staging has been proposed. However, a limited range of 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography-computed tomography (<sup>18</sup>F-FDG PET-CT) metabolic parameters has been investigated. Therefore, we aimed to evaluate the primary tumor invasiveness and the lymph node metastasis (LNM) of NPC from a metabolic perspective.</p><p><strong>Methods: </strong>A total of 435 NPC patients underwent <sup>18</sup>F-FDG PET/CT before treatment were retrospectively examined. The primary endpoint was differences in standard uptake value (SUV), lean body mass-normalized SUV (SUL), body surface area-normalized SUV (SUS), glucose-normalized SUV (GN), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and glucose-normalized total lesion glycolysis (GNTLG) of primary tumors and LNM between different T and N stages. The metabolic parameters associated with T and N staging were identified.</p><p><strong>Results: </strong>There were significant differences between all parameters relative to the primary tumor but no significant differences in any parameter relative to the LNM and T stages. Higher mean values of TGN<sub>max</sub>, TGN<sub>mean</sub>, TSUV<sub>peak</sub>, and TSUS<sub>max</sub> were associated with advanced T stages. Higher mean values of all the LNM parameters were associated with more advanced N stages. Only primary tumor metabolic tumor volume (TMTV), TSUV<sub>peak</sub>, TSUL<sub>max</sub>, and TSUS<sub>max</sub> showed a significant positive association with T staging, while lymph node metabolic tumor volume (LNMTV) and TSUS<sub>max</sub> were significantly positive in N staging.</p><p><strong>Conclusions: </strong>Our findings suggest that metabolic parameters are useful indicators of tumor invasiveness and LNM based on the Eighth Edition manual. Compared with volume-dependent parameters, TGN<sub>max</sub>, TGN<sub>mean</sub>, TSUV<sub>peak</sub>, and TSUS<sub>max</sub> may be better indicators of local tumor aggressiveness. SUS<sub>max</sub> of the primary tumor was associated with LNM. In addition to SUV<sub>max</sub>, other metabolic parameters (eg, SUL<sub>max</sub>, SUS<sub>max</sub>, GN<sub>max</sub>, and GN<sub>mean</sub>) could evaluate tumor aggressiveness and LNM better.</p>","PeriodicalId":48591,"journal":{"name":"Clinical Medicine Insights-Oncology","volume":"18 ","pages":"11795549231225419"},"PeriodicalIF":1.9000,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10845995/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Utility of <sup>18</sup>F-FDG-PET-CT Metabolic Parameters in Evaluating the Primary Tumor Aggressiveness and Lymph Node Metastasis of Nasopharyngeal Carcinoma.\",\"authors\":\"Yun Zhang, Yuxiao Hu, Shuang Zhao, Rong Huang\",\"doi\":\"10.1177/11795549231225419\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Following changes in primary tumor (T) and lymph node (N) staging for nasopharyngeal carcinoma (NPC) in the <i>Eighth Edition AJCC Cancer Staging Manual</i>, simplification of T staging has been proposed. However, a limited range of 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography-computed tomography (<sup>18</sup>F-FDG PET-CT) metabolic parameters has been investigated. Therefore, we aimed to evaluate the primary tumor invasiveness and the lymph node metastasis (LNM) of NPC from a metabolic perspective.</p><p><strong>Methods: </strong>A total of 435 NPC patients underwent <sup>18</sup>F-FDG PET/CT before treatment were retrospectively examined. The primary endpoint was differences in standard uptake value (SUV), lean body mass-normalized SUV (SUL), body surface area-normalized SUV (SUS), glucose-normalized SUV (GN), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and glucose-normalized total lesion glycolysis (GNTLG) of primary tumors and LNM between different T and N stages. The metabolic parameters associated with T and N staging were identified.</p><p><strong>Results: </strong>There were significant differences between all parameters relative to the primary tumor but no significant differences in any parameter relative to the LNM and T stages. Higher mean values of TGN<sub>max</sub>, TGN<sub>mean</sub>, TSUV<sub>peak</sub>, and TSUS<sub>max</sub> were associated with advanced T stages. Higher mean values of all the LNM parameters were associated with more advanced N stages. Only primary tumor metabolic tumor volume (TMTV), TSUV<sub>peak</sub>, TSUL<sub>max</sub>, and TSUS<sub>max</sub> showed a significant positive association with T staging, while lymph node metabolic tumor volume (LNMTV) and TSUS<sub>max</sub> were significantly positive in N staging.</p><p><strong>Conclusions: </strong>Our findings suggest that metabolic parameters are useful indicators of tumor invasiveness and LNM based on the Eighth Edition manual. Compared with volume-dependent parameters, TGN<sub>max</sub>, TGN<sub>mean</sub>, TSUV<sub>peak</sub>, and TSUS<sub>max</sub> may be better indicators of local tumor aggressiveness. SUS<sub>max</sub> of the primary tumor was associated with LNM. 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引用次数: 0
摘要
背景:第八版 AJCC 癌症分期手册》对鼻咽癌(NPC)的原发肿瘤(T)和淋巴结(N)分期进行了修改,并提出简化 T 分期。然而,对 2-脱氧-2-[氟-18] 氟-D-葡萄糖正电子发射断层扫描-计算机断层扫描(18F-FDG PET-CT)代谢参数的研究范围有限。因此,我们旨在从代谢角度评估鼻咽癌的原发肿瘤侵袭性和淋巴结转移(LNM):方法:我们对总共 435 例鼻咽癌患者在治疗前接受的 18F-FDG PET/CT 进行了回顾性研究。主要终点是不同 T 期和 N 期原发性肿瘤和 LNM 的标准摄取值 (SUV)、瘦体重归一化 SUV (SUL)、体表面积归一化 SUV (SUS)、葡萄糖归一化 SUV (GN)、代谢肿瘤体积 (MTV)、总病灶糖酵解 (TLG) 和葡萄糖归一化总病灶糖酵解 (GNTLG) 的差异。结果发现了与T期和N期分期相关的代谢参数:结果:相对于原发性肿瘤,所有参数之间均存在明显差异,但相对于 LNM 和 T 分期,任何参数均无明显差异。TGNmax、TGNmean、TSUVpeak和TSUSmax的平均值越高,T分期越晚。所有 LNM 参数的平均值越高,N 分期越晚。只有原发肿瘤代谢肿瘤体积(TMTV)、TSUVpeak、TSULmax 和 TSUSmax 与 T 分期呈显著正相关,而淋巴结代谢肿瘤体积(LNMTV)和 TSUSmax 与 N 分期呈显著正相关:我们的研究结果表明,根据第八版手册,代谢参数是肿瘤侵袭性和淋巴结转移的有用指标。与体积依赖性参数相比,TGNmax、TGNmean、TSUVpeak和TSUSmax可能是更好的局部肿瘤侵袭性指标。原发肿瘤的SUSmax与LNM相关。除 SUVmax 外,其他代谢参数(如 SULmax、SUSmax、GNmax 和 GNmean)也能更好地评估肿瘤侵袭性和 LNM。
The Utility of 18F-FDG-PET-CT Metabolic Parameters in Evaluating the Primary Tumor Aggressiveness and Lymph Node Metastasis of Nasopharyngeal Carcinoma.
Background: Following changes in primary tumor (T) and lymph node (N) staging for nasopharyngeal carcinoma (NPC) in the Eighth Edition AJCC Cancer Staging Manual, simplification of T staging has been proposed. However, a limited range of 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography-computed tomography (18F-FDG PET-CT) metabolic parameters has been investigated. Therefore, we aimed to evaluate the primary tumor invasiveness and the lymph node metastasis (LNM) of NPC from a metabolic perspective.
Methods: A total of 435 NPC patients underwent 18F-FDG PET/CT before treatment were retrospectively examined. The primary endpoint was differences in standard uptake value (SUV), lean body mass-normalized SUV (SUL), body surface area-normalized SUV (SUS), glucose-normalized SUV (GN), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and glucose-normalized total lesion glycolysis (GNTLG) of primary tumors and LNM between different T and N stages. The metabolic parameters associated with T and N staging were identified.
Results: There were significant differences between all parameters relative to the primary tumor but no significant differences in any parameter relative to the LNM and T stages. Higher mean values of TGNmax, TGNmean, TSUVpeak, and TSUSmax were associated with advanced T stages. Higher mean values of all the LNM parameters were associated with more advanced N stages. Only primary tumor metabolic tumor volume (TMTV), TSUVpeak, TSULmax, and TSUSmax showed a significant positive association with T staging, while lymph node metabolic tumor volume (LNMTV) and TSUSmax were significantly positive in N staging.
Conclusions: Our findings suggest that metabolic parameters are useful indicators of tumor invasiveness and LNM based on the Eighth Edition manual. Compared with volume-dependent parameters, TGNmax, TGNmean, TSUVpeak, and TSUSmax may be better indicators of local tumor aggressiveness. SUSmax of the primary tumor was associated with LNM. In addition to SUVmax, other metabolic parameters (eg, SULmax, SUSmax, GNmax, and GNmean) could evaluate tumor aggressiveness and LNM better.
期刊介绍:
Clinical Medicine Insights: Oncology is an international, peer-reviewed, open access journal that focuses on all aspects of cancer research and treatment, in addition to related genetic, pathophysiological and epidemiological topics. Of particular but not exclusive importance are molecular biology, clinical interventions, controlled trials, therapeutics, pharmacology and drug delivery, and techniques of cancer surgery. The journal welcomes unsolicited article proposals.