结合18F-FDG PET/CT播散特征的多参数模型用于预测小细胞肺癌预后的开发和验证

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-19 DOI:10.1016/j.ejrad.2025.112425

Yang Liu , Xin Zhou , Xiangxi Meng, Xiangxing Kong, Changzhi Du, Yan Cui, Yitong Liu, Jinyu Zhu, Yuan Yao, Chunxu Cao, Min Wang, Nan Li

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引用次数: 0

摘要

目的评价肿瘤播散特征、18F-FDG PET/CT基线代谢参数、临床指标及病理指标对小细胞肺癌（SCLC）的预后价值，并建立预后模型。方法回顾性分析基线接受18F-FDG PET/CT检查的ssclc患者，随机分为训练组和验证组（7:3）。收集肿瘤播散特征、代谢特征、形态特征及临床病理指标。采用Cox回归分析确定独立预后因素。采用受试者工作特征（ROC）曲线建立预后模型和相应的nomogram。结果共纳入303例SCLC患者（其中男性204例，女性99例，中位年龄62岁，四分位数范围56 ~ 67岁）。多因素Cox回归分析发现，年龄、分期、神经元特异性烯醇化酶（NSE）和两个最远病变之间的标准化距离（SDmax）是无进展生存期（PFS）的独立预后因素。预测6个月、12个月和24个月PFS的曲线下面积（AUC）值在训练队列中分别为0.790、0.778和0.750，在验证队列中分别为0.778、0.771和0.744。对于总生存期（OS），年龄、分期、NSE、全身代谢肿瘤体积（MTVwb）和SDmax是独立的预后因素。训练组预测1年、2年和3年OS的AUC值分别为0.861、0.830和0.799，验证组预测1年、2年和3年OS的AUC值分别为0.834、0.801和0.787。结论18F-FDG PET/CT基线的肿瘤播散特征是SCLC的一个新的独立预后因素。此外，结合传播特征、代谢参数和临床指标的模型在SCLC中显示出良好的预测能力。

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Development and validation of multiparametric models incorporating 18F-FDG PET/CT dissemination characteristic for predicting outcomes of small cell lung cancer

Objective

To evaluate the prognostic value of the tumor dissemination characteristic, metabolic parameters from baseline ¹⁸F-FDG PET/CT, clinical indicators, and pathological indicators in small cell lung cancer (SCLC), and to construct prognostic models.

Materials & Methods

SCLC patients who underwent baseline ¹⁸F-FDG PET/CT were retrospectively analyzed and randomly divided into training and validation cohorts (7:3). The tumor dissemination characteristic, metabolic characteristics, morphological features, and clinical and pathological indicators were collected. Cox regression analysis was employed to identify independent prognostic factors. Prognostic models and corresponding nomograms were developed and evaluated using receiver operating characteristic (ROC) curves.

Results

303 patients with SCLC were enrolled (including 204 males and 99 females; median age: 62 years, interquartile range: 56–67 years). Multivariate Cox regression analysis identified age, stage, neuron-specific enolase (NSE), and the standardized distance between the two farthest lesions (SD_max) as independent prognostic factors for progression-free survival (PFS). Area under curve (AUC) values for predicting 6-month, 12-month, and 24-month PFS were 0.790, 0.778, and 0.750 in the training cohort, and 0.778, 0.771, and 0.744 in the validation cohort. For overall survival (OS), age, stage, NSE, whole-body metabolic tumor volume (MTV_wb), and SD_max were independent prognostic factors. AUC values for predicting 1-year, 2-year, and 3-year OS were 0.861, 0.830, and 0.799 in the training cohort, and 0.834, 0.801, and 0.787 in the validation cohort.

Conclusion

The tumor dissemination characteristic from baseline ¹⁸F-FDG PET/CT is a novel independent prognostic factor in SCLC. Additionally, the models incorporating the dissemination characteristic, metabolic parameter, and clinical indicators demonstrate excellent predictive capabilities in SCLC.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.