摘要
目的探讨18F－FDG PET/CT显像肿瘤代谢参数对Ⅰ期NSCLC患者复发情况的预测价值。方法对2006年4月至2011年12月在上海仁济医院核医学科行PET/CT检查的有肺孤立性结节并经手术证实为Ⅰ期NSCLC的85例[男44，女41例，年龄（62.46±10.38）岁]患者进行回顾性分析。应用ROC曲线分析、Cox比例风险模型分析及Kaplan－Meier生存分析等对患者性别、年龄、病灶大小、病理类型、SUVmax、MTV和TLG等参数进行统计分析。结果85例Ⅰ期NSCLC患者中，随访期间21例复发，复发率24.7%（21/85），11例死亡，死亡率12.9%（11/85），中位随访时间44个月。SUVmax、MTV和TLG的中位值分别为4.100、3.048 cm3和7.970。通过ROC曲线计算，SUVmax、MTV和TLG评估无复发生存率的最佳临界值分别是7.115、4.701 cm3和12.015。Cox单因素分析结果显示，SUVmax（χ2＝22.091）、 MTV（χ2＝4.941）和TLG（χ2＝10.488）与患者无复发生存率有明显相关性（均P〈0.05）；患者性别、年龄、病灶大小和病理类型均不是患者复发的独立危险因素（χ2＝0.248～3.888，均P〉0.05）。Cox多因素分析结果显示，SUVmax（χ2＝16.902，HR＝15.426, P〈0.05）和TLG（χ2＝6.029，HR＝4.054, P〈0.05）是影响患者复发的独立危险因素。Kaplan－Meier方法分析结果显示，高SUVmax（〉7.115）组（χ2＝32.545，P〈0.05）和高TLG（〉12.015）组（χ2＝12.665，P〈0.05）的无复发生存率明显低于低SUVmax组和低TLG组。结论18F－FDG PET/CT所提供的SUVmax和TLG对Ⅰ期NSCLC患者的复发情况具有重要预测价值。
ObjectiveTo evaluate the predictive value of tumor metabolic indexes measured by 18F-FDG PET/CT in recurrence of stageⅠNSCLC after surgery.MethodsA total of 85 patients （44 males, 41 females, age （62.46±10.38） years） in Shanghai Renji Hospital with stageⅠNSCLC, who underwent 18F-FDG PET/CT and subsequent surgical resection, were retrospectively enrolled from April 2006 to December 2011. Gender, age, tumor size, pathology, SUVmax, MTV and TLG of the primary tumor were selected as variables. ROC curve analysis was used to analyze the cut off value. The prognostic significance of parameters for recurrence-free survival （RFS） was evaluated by univariate and multivariate analyses. Survival analysis was analyzed by Kaplan-Meier method.ResultsDuring follow-up period, tumor recurrence occurred in 21 patients （24.7%, 21/85） and 11 patients （12.9%, 11/85） died. The median follow-up period was 44 months. The median values of SUVmax, MTV and TLG were 4.100, 3.048 cm3 and 7.970, respectively. Cut off values of SUVmax, MTV and TLG were 7.115, 4.701 cm3 and 12.015 according to ROC curve analysis. Univariate Cox analysis showed that SUVmax（χ2=22.091）, MTV （χ2=4.941） and TLG（χ2=10.488） were associated with RFS（all P〈0.05）. But gender, age, tumor size, and pathology were not independent risk factors of recurrence （χ2=0.248-3.888, all P〉0.05）. Multivariate Cox analysis revealed that SUVmax （χ2=16.902, HR=15.426, P〈0.05） and TLG （χ2=6.029, HR=4.054, P〈0.05） were independent prognostic factors for recurrence. Kaplan-Meier survival analysis showed that the period of RFS in high SUVmax （〉7.115） group （χ2=32.545, P〈0.05） and in high TLG （〉12.015） group （χ2=12.665, P〈0.05） were lower than those in low SUVmax group and low TLG group.ConclusionThe SUVmax and TLG measured by 18F-FDG PET/CT have significant value for predicting the recurrence of stageⅠNSCLC.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2016年第6期486-489,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家自然科学基金（81471687）
