Department of Nuclear Medicine, Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, 120-1 Neungdong-ro, Hwayang-dong, Gwangjin-gu, Seoul, 143-729, Korea,
J Cancer Res Clin Oncol. 2014 Jan;140(1):89-98. doi: 10.1007/s00432-013-1545-7. Epub 2013 Nov 6.
We investigated fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT)-assessed metabolic tumor volume (MTV) and total lesion glycolysis (TLG) as prognostic factors in lung adenocarcinoma patients.
This retrospective study included 106 patients (19 stage I/II and 87 stage III/IV lung adenocarcinoma) who underwent FDG PET/CT before treatment. Standardized uptake value (SUV), MTV, and TLG (MTV × mean SUV) of each malignant lesion were measured. Whole MTV and whole TLG were the summation of all the MTV and TLG values in each patient. Survival analysis and FDG PET/CT parameters regarding epidermal growth factor receptor (EGFR) gene mutation status were evaluated.
Univariate survival analysis of stage III/IV patients identified high whole MTV (≥90), high whole TLG (≥600), and stage IV as significant predictors of poor progression-free survival. For overall survival, high whole MTV (≥90), high whole TLG (≥600), EGFR mutation-negative, and stage IV were significant poor prognostic predictors. After multivariate survival analysis, high whole MTV (P = 0.001), high whole TLG (P = 0.027), and stage IV (P = 0.006) were independent predictors of poor progression-free survival. High whole MTV (P < 0.001), high whole TLG (P = 0.001), and EGFR mutation-negative (P = 0.001) were independent prognostic predictors for poor overall survival. In a survival analysis of stage I/II patients, none was an independent prognostic predictor. No significant differences were found in FDG PET/CT parameters for EGFR mutation-negative and EGFR mutation-positive patients.
Assessment of MTV and TLG by FDG PET/CT in advanced lung adenocarcinoma patients provides useful information regarding prognosis.
我们研究了氟-18 氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）评估的代谢肿瘤体积（MTV）和总病变糖酵解（TLG）作为肺腺癌患者的预后因素。
这项回顾性研究纳入了 106 例（19 例 I/II 期和 87 例 III/IV 期肺腺癌）在治疗前接受 FDG PET/CT 的患者。测量每个恶性病变的标准摄取值（SUV）、MTV 和 TLG（MTV×平均 SUV）。全 MTV 和全 TLG 是每个患者的所有 MTV 和 TLG 值的总和。评估生存分析和与表皮生长因子受体（EGFR）基因突变状态相关的 FDG PET/CT 参数。
对 III/IV 期患者的单因素生存分析发现，高全 MTV（≥90）、高全 TLG（≥600）和 IV 期是无进展生存期不良的显著预测因素。对于总生存期，高全 MTV（≥90）、高全 TLG（≥600）、EGFR 突变阴性和 IV 期是显著的不良预后预测因素。经过多因素生存分析，高全 MTV（P=0.001）、高全 TLG（P=0.027）和 IV 期（P=0.006）是无进展生存期不良的独立预测因素。高全 MTV（P<0.001）、高全 TLG（P=0.001）和 EGFR 突变阴性（P=0.001）是总生存期不良的独立预后预测因素。在 I/II 期患者的生存分析中，没有一个是独立的预后预测因素。在 EGFR 突变阴性和 EGFR 突变阳性患者中，FDG PET/CT 参数没有发现显著差异。
在晚期肺腺癌患者中，FDG PET/CT 评估 MTV 和 TLG 可提供有关预后的有用信息。
