{"title":"新提出的第9版N描述符中PET/ ct定义的隐匿性淋巴结转移的生存影响:一项多中心研究。","authors":"Xinchen Shen,Tao Chen,Juemin Yu,Jialiang Wen,Haoran Ji,Zihan Guo,Minglei Yang,Bentong Yu,Yongxiang Song,Yangchun Chen,Long Zhao,Likun Hou,Longbing Ren,Deping Zhao,Yunlang She,Chang Chen,Dong Xie,Jiajun Deng","doi":"10.1007/s00259-025-07544-0","DOIUrl":null,"url":null,"abstract":"PURPOSE\r\nTo elucidate the potential reasons for the favourable prognosis of positron emission tomography/computed tomography (PET/CT)-defined occult N2 metastasis and its survival effect in the context of the newly proposed ninth edition N descriptors.\r\n\r\nMETHODS\r\nA total of 3565 patients who underwent preoperative PET/CT and surgical resection for non-small cell lung cancer were retrospectively included. Survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model.\r\n\r\nRESULTS\r\nThe incidence of single-station involvement was significantly higher (p < .001) in occult N2 metastasis (117/191, 61.3%) compared to evident N2 metastasis (83/198, 41.9%). The survival rates of patients with occult N2a (single-station N2 involvement) and occult N2b (multiple-station N2 involvement) were comparable to those of patients with clinically evident N2a and N2b, respectively (adjusted p >.20 for all). Conversely, single-station involvement was associated with a markedly superior prognosis than multiple-station involvement, whether for patients with occult N2 metastasis (5-year overall survival [OS]: 62.7% vs 50.1%, adjusted p = .04) or patients with clinically evident N2 metastasis (5-year OS: 50.3% vs 36.2%, adjusted p = .03). Cox regression analysis of the pathological N2 population further indicated that multiple-station involvement was a more robust prognostic factor than occult lymph node metastasis.\r\n\r\nCONCLUSIONS\r\nThe favourable prognosis of PET/CT-defined occult N2 metastasis may be attributed to the discrepancy in prognosis and proportion between occult N2a and clinically evident N2b. This external validation provided substantial evidence supporting the reasonableness and robustness of the newly proposed ninth edition N descriptors.","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"11 1","pages":""},"PeriodicalIF":7.6000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Survival effect of PET/CT-defined occult lymph node metastasis in the newly proposed ninth edition N descriptors: a multicentre study.\",\"authors\":\"Xinchen Shen,Tao Chen,Juemin Yu,Jialiang Wen,Haoran Ji,Zihan Guo,Minglei Yang,Bentong Yu,Yongxiang Song,Yangchun Chen,Long Zhao,Likun Hou,Longbing Ren,Deping Zhao,Yunlang She,Chang Chen,Dong Xie,Jiajun Deng\",\"doi\":\"10.1007/s00259-025-07544-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"PURPOSE\\r\\nTo elucidate the potential reasons for the favourable prognosis of positron emission tomography/computed tomography (PET/CT)-defined occult N2 metastasis and its survival effect in the context of the newly proposed ninth edition N descriptors.\\r\\n\\r\\nMETHODS\\r\\nA total of 3565 patients who underwent preoperative PET/CT and surgical resection for non-small cell lung cancer were retrospectively included. Survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model.\\r\\n\\r\\nRESULTS\\r\\nThe incidence of single-station involvement was significantly higher (p < .001) in occult N2 metastasis (117/191, 61.3%) compared to evident N2 metastasis (83/198, 41.9%). The survival rates of patients with occult N2a (single-station N2 involvement) and occult N2b (multiple-station N2 involvement) were comparable to those of patients with clinically evident N2a and N2b, respectively (adjusted p >.20 for all). Conversely, single-station involvement was associated with a markedly superior prognosis than multiple-station involvement, whether for patients with occult N2 metastasis (5-year overall survival [OS]: 62.7% vs 50.1%, adjusted p = .04) or patients with clinically evident N2 metastasis (5-year OS: 50.3% vs 36.2%, adjusted p = .03). Cox regression analysis of the pathological N2 population further indicated that multiple-station involvement was a more robust prognostic factor than occult lymph node metastasis.\\r\\n\\r\\nCONCLUSIONS\\r\\nThe favourable prognosis of PET/CT-defined occult N2 metastasis may be attributed to the discrepancy in prognosis and proportion between occult N2a and clinically evident N2b. This external validation provided substantial evidence supporting the reasonableness and robustness of the newly proposed ninth edition N descriptors.\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2025-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-025-07544-0\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-025-07544-0","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的在新提出的第9版N描述符的背景下,阐明正电子发射断层扫描/计算机断层扫描(PET/CT)定义的隐匿性N2转移预后良好的潜在原因及其对生存的影响。方法回顾性分析3565例术前行PET/CT及手术切除的非小细胞肺癌患者。生存率分析采用Kaplan-Meier法和Cox比例风险模型。结果隐匿性N2转移(117/191,61.3%)与明显N2转移(83/198,41.9%)相比,单站累及发生率显著增高(p < 0.001)。隐匿性N2a(单站N2受累)和隐匿性N2b(多站N2受累)患者的生存率分别与临床明显的N2a和N2b患者相当(所有患者调整p为0.20)。相反,无论是隐匿性N2转移患者(5年总生存率[OS]: 62.7% vs 50.1%,调整后p = 0.04)还是临床明显N2转移患者(5年生存率:50.3% vs 36.2%,调整后p = 0.03),单站受病灶的预后均明显优于多站受病灶。病理N2人群的Cox回归分析进一步表明,与隐匿性淋巴结转移相比,多站累及是一个更可靠的预后因素。结论PET/ ct定义的隐匿性N2转移预后良好可能与隐匿性N2a与临床明显的N2b在预后和比例上的差异有关。该外部验证提供了大量证据,支持新提出的第9版N描述符的合理性和稳健性。
Survival effect of PET/CT-defined occult lymph node metastasis in the newly proposed ninth edition N descriptors: a multicentre study.
PURPOSE
To elucidate the potential reasons for the favourable prognosis of positron emission tomography/computed tomography (PET/CT)-defined occult N2 metastasis and its survival effect in the context of the newly proposed ninth edition N descriptors.
METHODS
A total of 3565 patients who underwent preoperative PET/CT and surgical resection for non-small cell lung cancer were retrospectively included. Survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model.
RESULTS
The incidence of single-station involvement was significantly higher (p < .001) in occult N2 metastasis (117/191, 61.3%) compared to evident N2 metastasis (83/198, 41.9%). The survival rates of patients with occult N2a (single-station N2 involvement) and occult N2b (multiple-station N2 involvement) were comparable to those of patients with clinically evident N2a and N2b, respectively (adjusted p >.20 for all). Conversely, single-station involvement was associated with a markedly superior prognosis than multiple-station involvement, whether for patients with occult N2 metastasis (5-year overall survival [OS]: 62.7% vs 50.1%, adjusted p = .04) or patients with clinically evident N2 metastasis (5-year OS: 50.3% vs 36.2%, adjusted p = .03). Cox regression analysis of the pathological N2 population further indicated that multiple-station involvement was a more robust prognostic factor than occult lymph node metastasis.
CONCLUSIONS
The favourable prognosis of PET/CT-defined occult N2 metastasis may be attributed to the discrepancy in prognosis and proportion between occult N2a and clinically evident N2b. This external validation provided substantial evidence supporting the reasonableness and robustness of the newly proposed ninth edition N descriptors.
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.