摘要
目的探讨基线^(18)F-FDG PET/CT原发灶代谢参数对原发性恶性黑色素瘤的预后意义。方法回顾性分析南京大学医学院附属鼓楼医院2014年1月至2019年8月间35例(男21例、女14例,年龄35~85岁)确诊为原发性恶性黑色素瘤患者的临床资料,所有患者在术前均行^(18)F-FDG PET/CT检查。获取^(18)F-FDG PET/CT原发灶代谢参数:SUV_(max)、SUV_(mean)、SUV峰值(SUV_(peak));以40%SUV_(max)阈值作为体素边界,测量原发灶肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)。采用ROC曲线得出PET参数判断疾病进展的最佳阈值。采用Kaplan-Meier方法和Cox比例风险回归模型分析黑色素瘤特异性生存(MSS)和无进展生存(PFS)与PET代谢参数间的关系。结果中位随访15.4个月,20例病情进展,7例死亡。ROC曲线分析示,SUV_(max)、SUV_(mean)、SUV_(peak)、MTV和TLG的最佳阈值分别为3.95、2.45、2.65、3.60 cm^(3)和14.85 g(AUCs:0.742、0.790、0.728、0.655、0.693;P值:0.016、0.004、0.022、0.121、0.053)。Kaplan-Meier法及log-rank检验表明,SUV_(max)、SUV_(mean)、SUV_(peak)、MTV和TLG是原发性恶性黑色素瘤PFS的预后危险因素(χ^(2)值:4.06~8.35,均P<0.05)。多因素分析示,MTV[风险比(HR)=3.09,95%CI:1.08~8.86,P=0.036]和TLG(HR=3.36,95%CI:1.11~10.14,P=0.031)是PFS的独立预后危险因素,但不是MSS的预后危险因素(HR=5.14,P=0.080)。结论SUV_(max)、SUV_(mean)、SUV_(peak)对原发性恶性黑色素瘤患者疾病进展有一定的预测价值,MTV和TLG是原发性黑色素瘤疾病进展的最佳预测因素。
Objective To assess the prognostic value of pretreatment ^(18)F-FDG PET/CT metabolic parameters in patients with primary melanoma.Methods A retrospective analysis comprised of 35 patients(21 males,14 females,age:35-85 years;from January 2014 to August 2019;Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School)who were newly-diagnosed primary melanoma with preoperative ^(18)F-FDG PET/CT was conducted.^(18)F-FDG PET/CT metabolic parameters including SUV_(max),SUV_(mean),_(peak) of SUV(SUV_(peak))were obtained.Metabolic tumor volume(MTV)and total lesion glycolysis(TLG)of primary focus were measured automatically using the threshold of 40%SUV_(max).The optimal thresholds of PET parameters were obtained by using ROC curve analysis.The associations between melanoma-specific survival(MSS),progression-free survival(PFS)and PET/CT metabolic parameters were assessed using Kaplan-Meier method and Cox proportional hazards model.Results The median follow-up was 15.4 months,and 20 patients showed disease progression and 7 died.The cut-off values for SUV_(max),SUV_(mean),SUV_(peak),MTV and TLG were 3.95,2.45,2.65,3.60 cm^(3) and 14.85 g,respectively(AUCs:0.742,0.790,0.728,0.655,0.693;P values:0.016,0.004,0.022,0.121,0.053).Kaplan-Meier method and log-rank test showed that SUV_(max),SUV_(mean),SUV_(peak),MTV and TLG were predictors of PFS(χ^(2) values:4.06-8.35,all P<0.05).Multivariate analysis showed that MTV(hazard ratio(HR)=3.09,95%CI:1.08-8.86,P=0.036)and TLG(HR=3.36,95%CI:1.11-10.14,P=0.031)were significant predictors of PFS but not for MSS(HR=5.14,P=0.080).Conclusions SUV_(max),SUV_(mean) and SUV_(peak) of primary focus may help for predicting PFS of patients with primary melanoma.MTV and TLG of primary focus may be the best to predict PFS of primary melanoma.
作者
来瑞鹤
赵莲君
孙一文
滕月
李爱梅
许守林
蒋冲
Lai Ruihe;Zhao Lianjun;Sun Yiwen;Teng Yue;Li Aimei;Xu Shoulin;Jiang Chong(Department of Nuclear Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 21008,China;The Comprehensive Cancer Centre of Drum Tower Hospital,Medical School of Nanjing University,Nanjing 210008,China)
出处
《中华核医学与分子影像杂志》
CAS
CSCD
北大核心
2022年第3期144-148,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
