摘要
目的探讨基于^(18)F⁃脱氧葡萄糖(FDG)PET/CT不同SUV阈值计算的代谢参数与非小细胞肺癌(NSCLC)TNM分期相关性。方法回顾性分析经病理确诊的84例NSCLC患者资料,测量原发灶最大标准化摄取值(SUV_(max)),并分别采取自适应迭代算法(ALA)、固定阈值法(以2.5、3、4为阈值)及相对阈值法(以40%、(50%)为阈值)测量肿瘤代谢体积(MTV)及糖酵解总量(TLG),比较TNM分期之间的各参数差异并分析其相关性,通过ROC曲线评估各参数预测淋巴结转移的价值。结果各代谢参数在T、N分期之间差异均具有统计学意义(P值均<0.05),SUV_(max)、TLG_(3)、MTV_(4)、TLG_(4)、TLG_(50%)在M分期之间差异无统计学意义(P值均>0.05),MTVALA、TLGALA、MTV_(2.5)、TLG_(2.5)、MTV_(3)、MTV_(4)0%、TLG_(4)0%、MTV(50%)在M分期之间差异有统计学意义(P值均<0.05)),SUV_(max)与T分期呈中度正相关(r=0.529,P<0.001),基于不同阈值的MTV、TLG与T分期均呈高度正相关(r=0.701~0.772,P值均<0.001),其中以TLG_(2.5)与T分期的相关性最高(r=0.772,P<0.05)。各参数与N分期均呈低度正相关(r=0.320~0.398,P值均<0.05),SUV_(max)、TLG_(3)、MTV_(4)、TLG_(4)、TLG_(50%)与M分期均无明显相关(P值均>0.05),MTVALA、TLGALA、MTV_(2.5)、TLG_(2.5)、MTV_(3)、MTV_(4)0%、TLG_(4)0%、MTV(50%)与M分期均呈低度正相关(r=0.219~0.262,P值均<0.05)。各参数对淋巴结转移均具有良好的预测价值,其中以TLG_(2.5)诊断效能最高,但差异无统计学意义(Z=0.023~0.934,P值均>0.05),ROC曲线下面积为0.749(95%CI:0.629~0.869),敏感度、特异度和准确性分别为85.7%、55.9%和69.4%。结论基于不同阈值的MTV、TLG与肺癌临床分期密切相关,且相关性较SUV_(max)密切,以TLG_(2.5)与T、N分期的相关系数最高,具有较强的临床应用价值。
Objective To evaluate the correlation between metabolic parameters calculated by different SUV thresholds on ^(18)F-FDG PET/CT with TNM staging for non-small cell lung cancer.Methods The data of 84 pathologically proven non-small cell lung cancer(NSCLC)patients who underwent ^(18)F-FDG PET/CT examination were retrospectively ana⁃lyzed.Maximum standardized uptake value(SUV_(max))was measured,and metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were calculated by three methods:the absolute SUV threshold method(MTVp and TLGp,p=2.5,3,4);the fixed%SUV_(max) threshold method(MTVq%and TLGq%,q=40,50),and the adaptive iterative algorithm method(ALA)(MTVALA and TLGALA).The differences of parameters between TNM stage and the correlation between parameters and TNM stage were analyzed.The ROC curves evaluated the value of each parameter in predicting lymph node metastasis.Results All metabolic parameters were significantly different among T、N stage groups(P<0.05 for all).MTVALA,TLGALA,MTV_(2.5),TLG_(2.5),MTV_(3),MTV_(4)0%,TLG_(4)0%,MTV(50%)were significantly different between M stage groups(P<0.05 for all),but SUV_(max)、TLG_(3)、MTV_(4)、TLG_(4)、TLG_(50)%were not(P>0.05 for all).The correlation between SUV_(max) and T stage was positively moderate(r=0.529,P<0.001).The correlation between all metabolic parameters calculated by different SUV thresholds,and T stage was positively good(r=0.701-0.772,P<0.001 for all),and TLG_(2.5) showed the most re⁃markable relationship(r=0.772,P<0.05).The correlation between All metabolic parameters and N stage was positively fair(r=0.320-0.398,P<0.05 for all).MTVALA,TLGALA,MTV_(2.5),TLG_(2.5),MTV_(3),MTV_(4)0%,TLG_(4)0%,MTV(50%)were fairly positively correlated with M stage(r=0.219-0.262,P<0.05 for all),but SUV_(max)、TLG_(3)、MTV_(4)、TLG_(4)、TLG_(50)%were not(P>0.05 for all).All metabolic parameters had important value for the evaluation of lymph node metastasis.The best diag⁃nostic efficiency was TLG_(2.5)(AUC=0.749,95%CI:0.629-0.869),but the difference was not s
作者
朱俊辉
黄子康
周伟
陈薏帆
朱玉春
ZHU Junhui;HUANG Zikang;ZHOU Wei(Medical College of Jiangsu University,Zhenjiang,Jiangsu Province 212013,P.R.China)
出处
《临床放射学杂志》
北大核心
2023年第9期1447-1452,共6页
Journal of Clinical Radiology
基金
2019昆山市重点专科培育项目(昆卫[2020]3号)
江苏大学2023年度医教协同创新基金一般项目(编号:JDYY2023060)
昆山市第一人民医院2022年度广仁基金科研课题(临床研究专项)(编号:KRY-YN2022001)
2023年昆山市级科技专项(社会发展)指导性项目(编号:KSZ2311)。
