摘要
目的探讨老年食管鳞癌患者在接受抗肿瘤治疗前^(18)F-FDG PET/CT代谢参数,包括原发灶的最大标准化摄取值(SUV_(max))、全身肿瘤代谢体积(MTV_(tot))和全身病灶糖酵解总量(TLG_(wb))预测患者预后的价值。资料与方法回顾性分析73例经病理确诊的老年食管鳞癌患者的临床资料及治疗前^(18)F-FDG PET/CT显像资料,以SUV_(max)的40%作为阈值,获得MTV_(tot)和TLG_(wb)值,采用ROC曲线得出SUV_(max)、MTV_(tot)、TLG_(wb)预测总生存期(OS)的最佳界值点,采用单因素及多因素分析影响患者OS的预后因素。结果73例食管癌患者均表现为18F-FDG高摄取,原发灶SUV_(max)、MTV_(tot)、TLG_(wb)分别为16.65(10.96,20.83)、11.97(6.02,23.66)cm^(3)、103.33(44.67,240.32)。原发灶SUV_(max)、MTV_(tot)、TLG_(wb)预测患者OS的最佳界值点分别为12.56、9.28 cm^(3)、150.98。MTV_(tot)≤9.28 cm^(3)患者的3年OS率明显高于MTV_(tot)>9.28 cm^(3)者(72.4%比21.3%,P<0.001);TLG_(wb)≤150.98患者的3年OS率明显高于TLG_(wb)>150.98者(60.5%比17.3%,P<0.001)。病理分化程度、M分期、MTV_(tot)、TLG_(wb)是影响老年食管鳞癌患者的独立预后因素(HR=4.459、4.679、2.806、2.391,P<0.05)。结论治疗前^(18)F-FDG PET/CT显像所获得的MTV_(tot)及TLG_(wb)是老年食管鳞癌患者预后的独立危险因素。
Purpose To evaluate the prognostic value of metabolic parameters,including the maximum standardized uptake value(SUV_(max))of the primary lesion,total metabolic tumor volume(MTV_(tot))and whole-body total lesion glycolysis(TLG_(wb)),of ^(18)F-FDG PET/CT in elderly patients with esophageal squamous cell carcinoma.Materials and Methods A total of 73 patients with esophageal squamous cell carcinoma who underwent pretreatment ^(18)F-FDG PET/CT scan were retrospectively analyzed and reviewed.MTV_(tot) and TLG_(wb) of tumor tissue were calculated from PET/CT images with the threshold value of 40% of SUV_(max).The SUV_(max),MTV_(tot) and TLG_(wb) were obtained from the receiver operator characteristic curve(ROC)to predict the optimal cut-off value of overall survival(OS).The univariate and multivariate analysis were performed to analyze the predictive factor of OS.Results The primary lesions of all 73 cases showed high 18F-FDG uptakes,and the SUV_(max),MTV_(tot) and TLG_(wb) were 16.65(10.96,20.83),11.97(6.02,23.66)cm^(3) and 103.33(44.67,240.32),respectively.The optimal cut-off value of SUV_(max),MTV_(tot) and TLG_(wb) for predicting OS was 12.56,9.28 cm^(3) and 150.98,respectively.The 3-year OS rates of patients with low MTV_(tot)(≤9.28 cm^(3))were significantly higher than those of patients with high MTV_(tot)(>9.28 cm^(3))(72.4%vs.21.3%,P<0.001).The 3-year OS rates of patients with low TLG_(wb)(≤150.98)were significantly higher than those of patients with high TLG_(wb)(>150.98)(60.5%vs.17.3%,P<0.001).Differentiation,M stage,MTV_(tot) and TLG_(wb) were all independent risk factors for OS in elderly patient with esophageal squamous cell carcinoma(HR=4.459,4.679,2.806 and 2.391,P<0.05).Conclusion The pretreatment MTV_(tot) and TLG_(wb) of ^(18)F-FDG PET/CT could be the independent prognostic factors for OS in elderly patients with esophageal squamous cell carcinoma.
作者
邱云亮
郭喆
孙晋
丁重阳
QIU Yunliang;GUO Zhe;SUN Jin;DING Chongyang(Department of Nuclear Medicine,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第10期998-1002,共5页
Chinese Journal of Medical Imaging
