摘要
目的探讨^(18)F-氟脱氧葡萄糖(FDG)PET/CT代谢参数在预测非小细胞肺癌(NSCLC)患者纵隔淋巴结转移中的临床价值。方法回顾性分析2018年1月至2021年3月于安徽省阜阳市人民医院经组织病理学检查确诊为NSCLC的102例患者的临床资料,其中男性59例、女性43例,年龄33~90(66.0±11.2)岁。所有患者术前均行^(18)F-FDG PET/CT显像,分析并计算代谢参数,变异系数(CV)为病灶最大标准化摄取值(SUV_(max))的标准差(SD)与SUV_(max)的比值;LMV为淋巴结SUV_(max)与纵隔血池平均标准化摄取值(SUV_(mean))的比值;病灶葡萄糖酵解总量(TLG)为肿瘤代谢体积(MTV)与SUV_(mean)的乘积。绘制受试者工作特征(ROC)曲线,确定预测淋巴结转移的最佳临界值,并计算灵敏度和特异度。计数资料采用χ2检验或Fisher确切概率法进行比较;连续性计量资料采用独立样本t检验进行比较。采用单因素及多因素Logistic回归分析筛选淋巴结转移的预测因素。结果单因素Logistic回归分析结果显示,当患者肺部原发肿瘤的长径>30.0 mm或淋巴结的短径>10.0 mm时易发生淋巴结转移(61.9%对38.1%、59.5%对40.5%,χ^(2)=9.16、5.20,均P<0.05);转移组患者的原发肿瘤CV、淋巴结SUV_(max)和LMV均高于未转移组患者(46.7±6.1对29.4±6.0、5.9±1.9对2.8±1.6、2.2±0.6对1.4±0.3,t=13.81、8.60、3.97,均P<0.05)。多因素Logistic回归分析结果显示,淋巴结SUV_(max)[OR=2.2,95%可信区间(CI):1.30~3.80,P<0.05]和原发肿瘤CV(OR=1.5,95%CI:1.20~1.80,P<0.01)是影响淋巴结转移状态的独立危险因素。ROC曲线分析结果显示,原发肿瘤CV的曲线下面积(AUC)=0.97(SD=0.02,95%CI:0.94~0.99,P<0.01),当CV>30.5时,其诊断淋巴结转移的灵敏度为97.5%、特异度为41.7%;淋巴结SUV_(max)的AUC=0.91(SD=0.30,95%CI:0.85~0.97,P<0.01),当淋巴结SUV_(max)>3.1时,其诊断淋巴结转移的灵敏度和特异度分别为95.2%和23.3%。将2种危险因素进行联合诊断,得出的AUC=0.98(SD=0.01,95%CI:0.96~1
Objective To explore the clinical value of ^(18)F-fluorodeoxyglucose(FDG)PET/CT metabolic parameters in the prediction of mediastinal lymph node metastasis in patients with non-small cell lung cancer(NSCLC).Methods A total of 102 patients with NSCLC histopathologically confirmed from January 2018 to March 2021 in Fuyang People's Hospital were restrospectively analyzed in this study.The patients consisted of 59 males and 43 females aged 33–90(66.0±11.2)years.All patients underwent ^(18)F-FDG PET/CT imaging before operation to analyze and calculate the metabolic parameters.The coefficient of variation(CV)is the ratio of the standard deviation(SD)of the maximum standardized uptake value(SUV_(max))to SUV_(max) of the lesion;LMV is the ratio of the SUV_(max) of the lymph node to the mean standardized uptake value(SUV_(mean))of the mediastinal blood pool;the total lesion glycolysis(TLG)is the product of metabolic tumor volume(MTV)and SUV_(mean).The receiver operator characteristic(ROC)curve was drawn to determine the optimal cut-off value for predicting lymph node metastasis and calculate the sensitivity and specificity.Enumeration data were evaluated using χ^(2) test or Fisher's exact probability method,and continuous measurement data were compared using independent-sample t test.Univariate and multivariate Logistic regression analysis were used in screening the predictors of lymph node metastasis.Results The univariate Logistic regression analysis results showed that when the long diameter of the lung primary tumor was over 30.0 mm or the short diameter of the lymph nodes was over 10.0 mm,lymph node metastasis was likely to occur(61.9%vs.38.1%,59.5%vs.40.5%;χ2=9.16,5.20;both P<0.05);the CV of the primary tumor and the SUV_(max) and LMV of lymph nodes of patients with lymph node metastasis were higher than those of patients without lymph node metastasis(46.7±6.1 vs.29.4±6.0,5.9±1.9 vs.2.8±1.6,2.2±0.6 vs.1.4±0.3;t=13.81,8.60,3.97;all P<0.05).The multivariate Logistic regression analysis results suggested tha
出处
《国际放射医学核医学杂志》
2021年第8期495-500,共6页
International Journal of Radiation Medicine and Nuclear Medicine
