预测局部晚期胃癌患者生存结果的皮下脂肪组织[18F]FDG 摄取量和 CT 衍生的身体成分变量

IF 8.6 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Nuclear Medicine and Molecular Imaging Pub Date : 2025-04-24 DOI:10.1007/s00259-025-07296-x

Xiaoshan Chen, Xiaolin Chen, Xinming Zhao, Xiao Pang, Meng Dai, Yuhan Sun, Mengjiao Wang, Jingya Han, Yan Zhao

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引用次数: 0

摘要

目的：本研究旨在探讨皮下脂肪组织（SAT）和骨骼肌（SM）中的葡萄糖代谢变量对局部晚期胃癌患者总生存期（OS）的影响。方法：本研究对110例接受基线[18F]FDG PET/CT检查的晚期胃癌患者进行了回顾性研究。收集了人口统计学、临床和生存数据。PET/CT 评估了 SAT 和骨骼肌的平均标准化摄取值（SUVmean）以及身体成分测量，包括 SAT 面积、SAT 放射性密度、SM 面积和 SM 放射性密度。骨骼肌面积根据患者的身材进行归一化处理，得出骨骼肌指数（SMI）。根据 SAT SUVmean 的最佳临界值，将患者分为 SAT 摄取高的亚组和 SAT 摄取低的亚组。采用单变量、多变量回归分析、Kaplan-Meier生存分析和Spearman相关性分析来评估代谢活动和CT衍生的身体成分变量以及OS之间的关系。结果在110名平均年龄为（62.65 ± 13.25）岁的患者中，有58名（52.73%）患者在随访期间死亡。Cox回归分析发现，TNM分期、SAT SUV均值和SMI是影响OS的独立预后因素（所有P均为0.05）。值得注意的是，与 SAT 摄取低的患者相比，SAT 摄取高的患者的长期生存率明显较低（p < 0.001）。相关性分析表明，SAT SUVmean 与 SAT 辐射密度之间存在中度正相关（p < 0.001，r = 0.47），而 SAT SUVmean 与 SAT 面积之间存在显著的反相关（p < 0.001，r = -0.465）。结论SAT中[18F]FDG摄取量的增加与较高的SAT放射密度和较低的SAT面积相关，并缩短了晚期胃癌患者的生存期，突出了其作为不良预后生物标志物的潜力。

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Subcutaneous adipose tissue [18F]FDG uptake and CT-derived body composition variables for predicting survival outcomes in patients with locally advanced gastric cancer

Purpose

This study aimed to investigate the impact of glucose metabolism in subcutaneous adipose tissue (SAT) and skeletal muscle (SM) variables on overall survival (OS) in patients with locally advanced gastric cancer.

Methods

A retrospective study was conducted on 110 patients with advanced gastric cancer who underwent baseline [¹⁸F]FDG PET/CT. Demographic, clinical, and survival data were collected. Mean standardized uptake value (SUVmean) of SAT as well as skeletal muscle, and body composition measurement, including SAT area, SAT radiodensity, SM area, and SM radiodensity, were assessed on PET/CT. SM area was normalized for patient stature, resulting in the skeletal muscle index (SMI). Patients were stratified into subgroups with high and low SAT uptake based on the optimum cut-off value of the SAT SUVmean. The univariate, multivariate regression analysis, Kaplan–Meier survival analysis, and Spearman’s correlation analysis were employed to evaluate the associations among metabolic activity and CT-derived body composition variables as well as OS.

Results

Out of 110 patients with an average age of 62.65 ± 13.25 years, 58 (52.73%) patients died during follow-up. Cox regression analysis identified TNM stage, SAT SUVmean, and SMI as independent prognostic factors for OS (all p < 0.05). Notably, patients with elevated SAT uptake exhibited significantly poorer long-term survival compared to those with low SAT uptake (p < 0.001). Correlation analyses revealed a moderate positive association between SAT SUVmean and SAT radiodensity (p < 0.001, r = 0.47), whereas a significant inverse correlation was observed between SAT SUVmean and SAT area (p < 0.001, r = -0.465). Additionally, stratification by combined SAT SUVmean and SMI profiles showed that patients with low SAT uptake and high SMI exhibited a better prognosis than those with high SAT uptake and/or low SMI (p = 0.004 and p < 0.001).

Conclusion

Increased [¹⁸F]FDG uptake in SAT was correlated with higher SAT radiodensity as well as lower SAT area, and shortened survival in patients with advanced gastric cancer, underscoring its potential as a biomarker for adverse outcomes.

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来源期刊

European Journal of Nuclear Medicine and Molecular Imaging 医学-核医学

CiteScore

15.60

自引率

9.90%

发文量

392

审稿时长

3 months

期刊介绍： The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.