术前18F-FDG PET/CT显像对可切除非小细胞肺癌癌症患者的中期预后价值

中华核医学与分子影像杂志 Pub Date : 2020-04-25 DOI:10.3760/CMA.J.CN321828-20190801-00156

Xuetao Chen, Yuyi Zhang, Z. Yao, S. Luo, Congxia Chen, Xu Li

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引用次数: 0

摘要

目的探讨术前18f -氟脱氧葡萄糖(FDG) PET/CT成像对可切除非小细胞肺癌(NSCLC)患者中长期预后的影响。方法对2010年4月至2016年8月北京医院收治的70例可切除的非小细胞肺癌患者(男35例，女35例，中位年龄64岁)进行回顾性研究。所有患者均在1个月内行18F-FDG PET/CT显像，并行肺切除术合并纵隔或肺门淋巴结清扫。分析PET/CT影像学表现，包括原发病灶及纵隔或肺门淋巴结特征(原发病灶大小及最大标准化摄取值(SUVmax)、SUVmax及高代谢淋巴结分布(HML))，并对患者进行随访。生存结局指标定义为总生存期(OS)和无进展生存期(PFS)。生存率分析采用Kaplan-Meier法、log-rank法和Cox比例风险模型评估预测因素。结果随访时间为0.9 ~ 8.2年。70例患者中，31.4%(22/70)出现疾病进展，24.3%(17/70)死亡。在OS方面，原发病变SUVmax≥10、3cm和≤3cm的患者(4.8 vs 7.4年)、单侧纵隔或肺门HML、双侧或无HML的患者(4.4 vs 7.4年)、纵隔或肺门淋巴结SUVmax≥5.0和<5.0 (3.8 vs 7.3年)的患者(χ2值:10.13.5 ~ 15.238，均P<0.01)以及PFS (3.9 vs 6.7、3.8 vs 6.6、3.8 vs 6.4、3.3 vs 6.3年;χ2值:8.410 ~ 14.600,P均<0.01)。Cox多因素分析显示，原发病变大小和SUVmax是OS和PFS的独立预测因素(均P<0.01)。此外，纵隔或肺门HML分布对预测OS有边际意义(P=0.051)。结论术前18F-FDG PET/CT原发病灶大小和SUVmax是影响术后NSCLC生存的预测因素。纵隔或肺门HML的分布可能对术后NSCLC的生存预测有重要意义。关键词:肺癌，非小细胞肺;正电子发射断层扫描;断层扫描，x射线计算机;脱氧葡萄糖;预后

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Mid-long-term prognostic value of preoperative 18F-FDG PET/CT imaging on patients with resectable non-small cell lung cancer

Objective To investigate the role of preoperative 18F-fluorodeoxyglucose (FDG) PET/CT imaging in mid-long-term prognosis of patients with resectable non-small cell lung cancer (NSCLC). Methods Seventy resectable NSCLC patients (35 males, 35 females, median age 64 years) in Beijing Hospital between April 2010 and August 2016 were enrolled into this retrospectively study. All patients underwent 18F-FDG PET/CT imaging followed by pulmonary resection with mediastinal or hilar lymph nodes dissection within 1 month. The findings of PET/CT imaging including characteristics of primary lesions and mediastinal or hilar lymph nodes (size and maximum standardized uptake value (SUVmax) of primary lesion, SUVmax and distribution of high metabolic lymph nodes (HML)) were analyzed, and patients were followed up. Survival outcome indicators were defined as overall survival (OS) and progression-free survival (PFS). Survival analysis was conducted by Kaplan-Meier method, log-rank method and Cox proportional hazard models to assess the predictive factors. Results Patients were followed up for 0.9-8.2 years. Among 70 patients, 31.4% (22/70) had disease progression and 24.3% (17/70) died. As for OS, there were significantly differences between patients with SUVmax of primary lesion≥10 and 3 cm and ≤3 cm (4.8 vs 7.4 years), with unilateral mediastinal or hilar HML and bilateral sides or without HML (4.4 vs 7.4 years), with SUVmax of mediastinal or hilar lymph nodes ≥5.0 and <5.0 (3.8 vs 7.3 years) (χ2 values: 10.135-15.238, all P<0.01), as well as PFS (3.9 vs 6.7, 3.8 vs 6.6, 3.8 vs 6.4, 3.3 vs 6.3 years; χ2 values: 8.410-14.600, all P<0.01). Cox multivariate analysis demonstrated that the size and SUVmax of primary lesion were independent predictive factors of OS and PFS (all P<0.01). Moreover, the distribution of mediastinal or hilar HML had marginal significance in predicting OS (P=0.051). Conclusions Size and SUVmax of primary lesion in preoperative 18F-FDG PET/CT imaging are predictive factors for the survival of postoperative NSCLC. The distribution of the mediastinal or hilar HML may have significance for the survival prediction of postoperative NSCLC. Key words: Carcinoma, non-small-cell lung; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Prognosis

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.