Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Ann Nucl Med. 2010 Dec;24(10):697-705. doi: 10.1007/s12149-010-0412-8. Epub 2010 Sep 8.
The maximum standardized uptake value (SUV(max)) on (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET) within the primary tumor may predict outcome in patients with surgically resected non-small cell lung cancer (NSCLC). However, it remains uncertain whether the SUV(max) of the primary tumor predicts outcome after chemotherapy in advanced NSCLC. Thus, we evaluated the ratio of SUV(max) of the metastatic tumor to the primary tumor (M/P ratio) to determine whether it could be a useful marker in predicting response and outcome after chemotherapy in advanced NSCLC.
Chemo-naïve patients with advanced NSCLC who had locoregional lymph nodes and/or distant metastases other than brain, were eligible for inclusion in this study. Response and survival were analyzed according to the SUV(max) of primary tumor, the ratio of the SUV(max) of the tumor to the mean SUV of the mediastinum (T/M ratio) and M/P ratio.
One hundred and four consecutive patients were included in the retrospective study. Patients with high M/P ratio exhibited significantly lower response rates. The value of SUV(max) and T/M ratio were not associated with the response to initial chemotherapy. In the univariate analysis, T/M ratio and SUV(max) were significantly associated with poor outcome. However, the outcome of non-adenocarcinoma was unaffected by T/M ratio and SUV(max). Multivariate analysis confirmed that high M/P ratio was a significant independent factor predicting a poor outcome.
High M/P ratio was associated with a poor response to initial chemotherapy and was a significant independent factor in predicting poor outcome in advanced NSCLC patients with metastatic tumors other than in brain.
在接受手术切除的非小细胞肺癌（NSCLC）患者中，原发肿瘤的最大标准化摄取值（SUV(max)）可能预测预后。然而，原发肿瘤的 SUV(max)是否能预测晚期 NSCLC 化疗后的预后仍不确定。因此，我们评估了转移灶与原发灶的 SUV(max)比值（M/P 比值），以确定其是否可以作为预测晚期 NSCLC 化疗后反应和预后的有用标志物。
本研究纳入了未经化疗的局部区域淋巴结和/或脑外远处转移的晚期 NSCLC 患者。根据原发肿瘤 SUV(max)、肿瘤与纵隔平均 SUV 比值（T/M 比值）和 M/P 比值分析患者的反应和生存情况。
本回顾性研究共纳入 104 例连续患者。高 M/P 比值患者的反应率显著降低。SUV(max)值和 T/M 比值与初始化疗的反应无关。单因素分析显示，T/M 比值和 SUV(max)与不良预后显著相关。然而，非腺癌的 T/M 比值和 SUV(max)与预后无关。多因素分析证实，高 M/P 比值是预测不良预后的独立因素。
高 M/P 比值与初始化疗反应不良相关，是预测脑外转移的晚期 NSCLC 患者不良预后的独立因素。
