华南肿瘤学国家重点实验室//中山大学肿瘤防治中心 核医学科,广东,广州,510060
网络首发:2017-09-16,
纸质出版:2017
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林晓平, 梁培炎, 胡莹莹. 18 F-FDG PET/CT体积代谢参数在局限期小细胞肺癌预后的预测价值[J]. 中山大学学报(医学科学版), 2017,38(5).
Value of 18 F-FDG PET/CT with Volume Metabolic Parameters for Prognosis Evaluation in Limited-Disease Small Cell Lung Cancer[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(5).
目的】探讨治疗前 18 F-FDG PET/CT不同代谢参数对局限期小细胞肺癌(SCLC)预后的预测价值。【方法】回顾 性分析 2005 年 6 月至 2016 年 12 月在我院经病理或细胞学、全面影像学检查确诊的局限期 SCLC,在治疗前 4 周进行 18 F- FDG PET/CT全身显像的54例患者纳入本研究。记录患者一般特征信息,治疗前KPS评分,吸烟史,发病时是否体重减轻, 治疗前同期LDH、NSE、OS和PFS。采用固定阈值法系统自动勾画病灶(原发灶+转移灶),所有病灶(原发灶+转移灶)勾画 在1个VOI内,自动测量及记录该VOI内的SUV max 、SUV mean 及SUV peak ,自动测量并记录病灶固定阈值为SUV max 的40%及50%的 TLG及MTV,分别命名为TLG 40% 、TLG 50% 、MTV 40% 、MTV 50% 。采用Kaplan-Meier法进行生存分析比较,Cox模型分析预后因素。 【结果】本组 18 F-FDG 代谢参数结果:pSUV max 中位数为 11.4(1.7 ~ 24.6),SUV max 中位数为 13.92(2.61 ~ 43.28),SUV mean 中位 数为 8.31(1.71 ~ 26.85),SUV peak 中位数为 10.51(1.49 ~ 27.48)。TLG 40% 中位数 340.22(16.58 ~ 2 827.26)、TLG 50% 中位数为 215.645(1.70 ~ 2 270.36)、MTV 40% 中位数 36.71(1.15 ~ 259.47)cm 3 、MTV 50% 中位数为 19.65(0.93 ~ 1 900.00)cm 3 。局限期 SCLC 患者预后单因素及多因素分析结果显示:TLG 50% 是 OS 的独立预后因素(P = 0.013),但不是 PFS 预后影响因素(P> 0.05)。pSUV max 、SUV max 、SUV mean 、SUV peak 均不是OS及PFS预后影响因素(P>0.05)。【结论】体积代谢参数TLG 50% 是LD期SCLC 总生存时间的独立预后因素。 18 F-FDG PET/CT体积代谢参数(TLG及MTV)与局限期SCLC预后有关,可为临床医生个体化 治疗提供依据。
【Objective】To investigate the prognostic value of 18 F-FDG PET/CT with different metabolic parameters in newly diagnosed limited-disease(LD)small cell lung cancer(SCLC).【Methods】Retrospective analysis was carried out in the patients between June 2005 to December 2016 in our hospital confirmed of LD SCLC by pathology or cytology and comprehensive imaging. Fifty-four patients were recruited. Record the general characteristics of patients,pre-treatment KPS score,smoking status,weight loss,serum LDH,NSE,OS,PFS. All lesions(primary lesions + metastases)were sketched out within one VOI,and the SUV max , SUV mean and SUV peak in the VOI were automatically measured and recorded. The automatic measurement was performed by the fixed threshold method. The thresholds of tumor of MTV and TLG were 40% and 50% of SUV max . The TLG and MTV were identified as TLG 40% ,TLG 50% ,MTV 40% and MTV 50% respectively. Kaplan-Meier method was used for survival analysis. All the prognostic factors were analyzed by Cox model.【Result】The median SUV max was 13.92(2.61 ~ 43.28),the median of SUV mean was 8.31(1.71 ~ 26.85) and the median of SUV peak was 10.51(1.49 ~ 27.48). The median of TLG 40% was 340.22(16.58 ~ 2 827.26),the median of TLG 50%was 215.645(1.70 ~ 2 270.36),the median of MTV 40% was 36.71(1.15 ~ 259.47 cm 3 ),the median of MTV 50% was 19.65(0.93 ~ 1900.00)cm 3 . Univariate and multivariate analysis of metabolic index and prognosis showed that TLG 50% was the prognostic factor of OS(P = 0.013),but not of PFS(P > 0.05). The SUV max ,SUV mean and SUV peak were not the prognostic factors of OS and PFS(P > 0.05). 【Conclusion】The volume metabolic parameters TLG 50% was the independent prognostic factor of the overall survival time of the LD SCLC. The volume metabolic parameters(TLG and MTV)of 18 F-FDG PET/CT were related to the prognosis of SCLC,which could provide the basis for individual chemotherapy.
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