Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
Eur J Cardiothorac Surg. 2013 Jan;43(1):e7-e12. doi: 10.1093/ejcts/ezs573. Epub 2012 Nov 4.
In a previous study, we found that a standardized-uptake value (SUV) index obtained from positron emission tomography (PET)/computed tomography (CT) data was significantly correlated with prognosis in patients with pathological Stage I lung adenocarcinoma. However, this value has not been studied in early stage lung cancer patients undergoing limited resection. In this study, we investigated if an SUV index could be used to identify patients with clinical Stage IA lung cancers that were appropriate for limited resection.
This was a retrospective study of prospectively collected data from 183 patients with clinical Stage IA non-small-cell lung cancer undergoing both PET-CT examinations and surgery from May 2004 to December 2010. A corrected SUV was defined as the SUV index, which was calculated from the ratio of the tumour SUV(max) to the liver SUV(mean). The associations between survival, recurrence and several clinical factors, including the SUV index, were evaluated.
The following pathological stages were identified: Stage IA (n = 133; 72.7%), Stage IB (n = 31; 16.9%), Stage IIA (n = 11; 6.0%), Stage IIB (n = 1; 0.5%) and Stage IIIA (n = 7; 3.8%). There were 50 upstaged cases (27.3%). The 5-year overall survival, 5-year cancer-specific survival and 5-year freedom from recurrence (FFR) rates after surgery were 83.5, 91.6 and 83.1%, respectively. Twenty-six (14.2%) patients developed recurrences. Multivariate analysis showed that an SUV index was a significant predictive factor for recurrence (P = 0.01). The 5-year FFR rates in patients with an SUV indices <1.0 and ≥1.0 were 100 and 77.1%, respectively (P < 0.01). The 5-year cancer-specific survival rates in patients with an SUV indices <1.0 and ≥1.0 were 100 and 88.7%, respectively (P = 0.04).
In clinical Stage IA lung cancer patients, the SUV index was a significant predictive marker for recurrence. Patients with SUV indices <1.0 were less likely to have a recurrence. Thus, clinical Stage IA patients with SUV indices <1.0 should be candidates for limited resection.
在之前的研究中，我们发现正电子发射断层扫描（PET）/计算机断层扫描（CT）数据得出的标准化摄取值（SUV）指数与病理 I 期肺腺癌患者的预后显著相关。然而，这一数值尚未在接受局限性切除术的早期肺癌患者中进行研究。本研究旨在探讨 SUV 指数是否可用于识别临床 I 期肺癌患者中适合局限性切除术的患者。
这是一项回顾性研究，纳入了 2004 年 5 月至 2010 年 12 月期间接受 PET-CT 检查和手术的 183 例临床 I 期非小细胞肺癌患者的前瞻性数据。校正 SUV 定义为肿瘤 SUV(max)与肝脏 SUV(mean)的比值计算得出的 SUV 指数。评估了生存、复发与 SUV 指数等若干临床因素之间的关系。
病理分期为：IA 期（n=133；72.7%）、IB 期（n=31；16.9%）、IIA 期（n=11；6.0%）、IIB 期（n=1；0.5%）和 IIIA 期（n=7；3.8%）。有 50 例病例升级（27.3%）。术后 5 年总生存率、5 年癌症特异性生存率和 5 年无复发生存率（FFR）分别为 83.5%、91.6%和 83.1%。26 例（14.2%）患者出现复发。多因素分析显示，SUV 指数是复发的显著预测因素（P=0.01）。SUV 指数<1.0 和≥1.0 的患者 5 年 FFR 率分别为 100%和 77.1%（P<0.01）。SUV 指数<1.0 和≥1.0 的患者 5 年癌症特异性生存率分别为 100%和 88.7%（P=0.04）。
在临床 I 期肺癌患者中，SUV 指数是复发的显著预测指标。SUV 指数<1.0 的患者复发的可能性较低。因此，SUV 指数<1.0 的临床 I 期患者应作为局限性切除术的候选者。
