摘要
目的 探讨18 F-FDG PET/CT显像中原发灶SUVmax、SUVmean、MTV、TLG在食管癌术后患者预后评估中的价值.方法 回顾性分析2007年10月至2015年11月行手术治疗的61例食管癌患者[男51例,女10例;年龄50~81（中位年龄64）岁]的临床资料.所有患者术前均行18 F-FDG PET/CT检查.分析原发灶的SUVmax、SUVmean、MTV、TLG与临床病理因素的关系,以两样本t检验、单因素方差分析、Mann-Whitney u或Kruskal-Wallis H检验比较组间代谢参数差异;采用ROC曲线获得SUVmax、SUVmean、MTV、TLG预测患者总体生存（OS）的最佳界值点;采用Kaplan-Meier法及log-rank检验进行单因素生存分析;采用Cox比例风险模型进行多因素生存分析.结果 MTV、TLG均与病灶长度、N分期、临床分期有关,而SUVmax、SUVmean仅与病灶长度有关,组间差异有统计学意义（t=-2.396,F=4.206、4.471;z=-3.051,χ2=8.908、9.796;t=-2.417、-2.423;均P〈0.05）.SUVmax、SUVmean、MTV、TLG预测患者OS的最佳界值点分别为11.76、7.06、24.35 cm3、166.84 g.单因素预后分析显示,淋巴结转移、临床分期及TLG与预后有关（χ2=14.683、7.139、11.669,均P〈0.05）;多因素预后分析显示,淋巴结转移及TLG是影响食管癌术后总体生存的独立预后因素（β=-1.472、-1.223,Wald值=5.224、4.668,均P〈0.05）.结论 在食管癌患者术后预后评估中,18 F-FDG PET/CT测得的原发灶TLG较SUVmax、SUVmean、MTV更具参考价值.
Objective To investigate the prognostic value of SUVmax , SUVmean , MTV and TLG cal-culated from 18 F-FDG PET/CT in patients with postoperative esophageal cancer. Methods Sixty-one pa-tients （ 51 males, 10 females;age ranged 50-81 （ median：64） years） with esophageal cancer who under-went preoperative 18 F-FDG PET/CT from October 2007 to November 2015 were retrospectively analyzed. The relation of SUVmax , SUVmean , MTV and TLG in primary lesions with clinic pathological factors was ana-lyzed. Differences of metabolic parameters were compared with two-sample t test, one-way analysis of vari-ance, Mann-Whitney u test or Kruskal-Wallis H test. The optimal cutoff points of SUVmax , SUVmean , MTV and TLG for predicting overall survival （ OS） were investigated by ROC curve analysis. The Kaplan-Meier method and log-rank test were used to perform univariate survival analysis, and Cox proportional hazards model was used for multivariate analysis. Results MTV and TLG were associated with tumor length, N stage and clinical stage, while SUVmax and SUVmean were only associated with tumor length （ t=-2.396, F=4.206, 4. 471;z=-3.051,χ2=8.908, 9.796;t=-2.417,-2.423;all P〈0. 05） . The optimal cutoff points of SUVmax, SUVmean, MTV and TLG were 11.76, 7.06, 24.35 cm3 and 166. 84 g, respectively. Univariate analysis of OS showed that the lymphatic metastasis, clinical stage and TLG were all significantly associated with the patient outcome （χ2=14.683, 7.139, 11.669, all P〈0.05） . Multivariate analysis showed that lym-phatic metastasis and TLG were the independent predictors for OS （β=-1. 472, -1. 223; Wald=5. 224, 4. 668;both P〈0.05） . Conclusion For predicting the prognosis of esophageal cancer after operation, TLG of the primary tumor may be more valuable than SUVmax , SUVmean and MTV.
作者
丁重阳
郭喆
杨文平
孙晋
李天女
Ding Chongyang Guo Zhe Yang Wenping Sun Jin Li Tiannyu(Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)
出处
《中华核医学与分子影像杂志》
北大核心
2017年第10期607-612,共6页
Chinese Journal of Nuclear Medicine and Molecular Imaging
