摘要
目的：分析18 F-FDG PET／CT显像在初诊小细胞肺癌（ SCLC）预后评估中的价值。方法回顾性分析2008年1月至2013年12月按常规方法行18 F-FDG PET／CT检查并经病理证实的初诊SCLC患者49例（男35例，女14例；中位年龄61岁），根据检查时临床资料进行功能状态（ PS）评分，根据检查结果分期并随访（≥6个月）生存期。统计学分析采用两独立样本t检验、Kaplan-Meier生存分析、log-rank非参数检验及Cox回归生存分析。结果（1）49例患者随访过程中死亡20例，失访1例，45例患者（91．84％）存在转移。根据18F-FDG PET／CT图像进行分期，疾病局限（LD）期患者27例，疾病扩展（ED）期患者22例。（2）中位OS为23．68个月，PFS为19．93个月。 LD期患者的中位OS （35．30个月）及PFS（28．87个月）均明显长于ED期患者的中位OS（12．57个月）及PFS（11．30个月）（χ2＝18．810和13．647，均P＜0．05）。（3）49例患者原发灶SUVmax为1．97～21．50。 LD期患者原发灶SUVmax （8．27±3．14）与ED期患者原发灶SUVmax（9．68±5．36）间差异无统计学意义（P＞0．05）。 SUVmax与患者的OS及PFS无相关性（均P＞0．05），且在LD和ED期患者中，高、低SUVmax亚组的中位OS与PFS间差异亦无统计学意义（χ2＝0．001～0．565，均P＞0．05）。（4）根据18F-FDG PET／CT得到的分期结果与PS评分为SCLC的独立预后因素（风险比分别为3．93和5．00，均P＜0．05），原发灶SUVmax与预后并无显著相关性。结论18 F-FDG PET／CT 显像时，患者的 PS 评分以及根据显像结果进行的分期为SCLC患者独立预后因素，而原发灶SUVmax与预后的关系有待进一步研究。
Objective To evaluate the prognostic value of 18 F-FDG PET/CT in untreated small cell lung cancer （ SCLC） . Methods A total of 49 SCLC patients（ 35 males, 14 females, median age 61 years） with pathologically confirmed SCLC had underwent 18 F-FDG PET/CT scan before treatment from January 2008 to December 2013 and were retrospectively analyzed in this study. Clinical staging were mainly deter-mined by 18 F-FDG PET/CT scan. Performance status （ PS） was acquired according to the clinical symptoms before PET examination. Patients were followed up for at least 6 months and the survival interval was recor-ded. Two-sample t test, Kaplan-Merier, log-rank and Cox regression analysis were used for statistical analy-sis. Results （1）Among 49 patients, 20 died during the follow-up, 1 patient was lost to follow-up, and 45 patients（91.84%） had metastasis. Patients with limited disease （LD） and extensive disease （ED） were 27 and 22 respectively according to 18F-FDG PET/CT imaging. （2）The median OS was 23.68 months and me-dian PFS was 19.93 months. LD patients had significantly longer OS and PFS than ED patients （35.30 months vs 12.57 months, 28.87 months vs 11.30 months;χ2=18.810, 13.647, both P〈0.05）. （3）SUVmax of primary tumor ranged from 1.97 to 21.50. The SUVmax of primary foci had no difference between LD（8.27± 3.14） and ED（9.68±5.36）patients（P〉0.05）. SUVmax of primary tumor showed no significant correlation＆amp;nbsp;with OS and PFS （both P〉0.05）.There were no significant differences in OS and PFS between low SUVmax group and high SUVmax group in both LD and ED patients （χ2=0.001-0.565, all P〉0.05）. （4） Staging based on 18 F-FDG PET/CT results and PS score were independent prognostic factors （ hazard ratios：3.93, 5-00, both P〈0.05） , while SUVmax showed no significant prognostic value. Conclusions PS score before PET scan and imaging staging based on 18 F-FDG PET/CT results are independent prognostic factors. The predictive value of primary
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2015年第6期442-445,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
