Department of Surgery, University Hospital of Wales, Cardiff, UK.
Clin Radiol. 2013 Apr;68(4):352-7. doi: 10.1016/j.crad.2012.08.012. Epub 2012 Sep 13.
To determine the correlation between 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) defined maximum standardized uptake value (SUVmax) and endoluminal ultrasound-defined tumour volume (EDTV) in patients with oesophageal cancer (OC) and their relative prognostic significance.
One hundred and eighty-five consecutive patients with OC were staged using CT, endoscopic ultrasound (EUS), and PET/CT. The maximum potential EDTV was calculated (πr(2)L, where r = tumour thickness and L = total length of disease including proximal and distal lymph node metastases). Primary outcome measure was survival from diagnosis.
Ninety-one percent of patients (168/185) had FDG-avid tumours on PET/CT. SUVmax correlated positively and significantly with EDTV (Spearman's rho = 0.339, p = 0.001). On univariate analysis, survival was inversely related to the PET/CT lymph node metastasis count (LNMC, p = 0.015), EUS N stage (p = 0.002), EDTV (<48 cm(3), p = 0.001), EUS total length of disease (p = 0.001), SUVmax (p = 0.002), PET/CT N stage (p < 0.0001), and EUS LNMC (p < 0.0001). On multivariate analysis two factors were significantly and independently associated with survival: EDTV (HR, 3.118; 95% CI: 1.357-7.167; p = 0.007), and PET/CT N stage (HR, 0.496; 95% CI: 0.084-1.577; p = 0.022).
EDTV and PET/CT N stage were important predictors of survival and further research is needed to identify critical prognostic values.
确定 2-[(18)F]-氟-2-脱氧-D-葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）定义的最大标准化摄取值（SUVmax）与食管癌（OC）患者内镜超声定义的肿瘤体积（EDTV）之间的相关性及其相对预后意义。
185 例连续 OC 患者采用 CT、内镜超声（EUS）和 PET/CT 分期。计算最大潜在 EDTV（πr(2)L，其中 r=肿瘤厚度，L=包括近端和远端淋巴结转移的疾病总长度）。主要观察指标为诊断后的生存。
91%（168/185）的患者 PET/CT 显示 FDG 摄取肿瘤。SUVmax 与 EDTV 呈正相关且显著相关（Spearman's rho=0.339，p=0.001）。单因素分析显示，生存与 PET/CT 淋巴结转移计数（LNMC，p=0.015）、EUS N 分期（p=0.002）、EDTV（<48 cm(3)，p=0.001）、EUS 疾病总长度（p=0.001）、SUVmax（p=0.002）、PET/CT N 分期（p<0.0001）和 EUS LNMC（p<0.0001）呈负相关。多因素分析显示，有两个因素与生存显著独立相关：EDTV（HR，3.118；95%CI：1.357-7.167；p=0.007）和 PET/CT N 分期（HR，0.496；95%CI：0.084-1.577；p=0.022）。
EDTV 和 PET/CT N 分期是生存的重要预测因素，需要进一步研究以确定临界预后值。
