Lebioda Andrzej, Makarewicz Roman, Małkowski Bogdan, Dancewicz Maciej, Kowalewski Janusz, Windorbska Wieslawa
Clinic of Oncology and Brachytherapy, Collegium Medicum of Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Department of Nuclear Medicine, Center of Oncology in Bydgoszcz, Poland ; Department of Positron Emission Tomography and Molecular Imagining, Collegium Medicum of Bydgoszcz, Nicolaus Copernicus University in Torun, Poland.
Rep Pract Oncol Radiother. 2013 Jan 5;18(2):76-81. doi: 10.1016/j.rpor.2012.11.002. eCollection 2013.
The study aimed to determine a prognostic value of primary tumor volume measured on the basis of integrated positron emission tomography-computerized tomography (PET-CT) in terms of mediastinal nodal metastases (N2) prediction in non-small-cell lung cancer (NSCLC) patients with PET-CT N2 negative lymph nodes.
The records of 70 potentially operable NSCLC patients treated with surgical resection were analyzed. All patients underwent diagnostic, preoperative PET-CT, which was the basis for tumor volume calculations as well as the evaluation of N2 nodes status. The logistic regression analysis was employed to determine correlation between mediastinal nodal involvement and volume of primary tumor (izoSUV2.5 volume), that is the volume of primary tumor inside SUV 2.5 line, tumor histology, location (peripheral vs. central), hilar node status.
A statistically significant correlation between mediastinal node involvement and izoSUV2.5 volume, tumor histology, locations peripheral vs. central and hilar node status was found. The risk of mediastinal lymph node metastasis is 24% for tumor volume of 100 cm(3) and increases up to 40% for tumor volume of 360 cm(3). An increase of tumor volume by 1 cm(3) increases the risk of lymph node disease by 0.3%. Tumor histology adenocarcinoma vs. squamous cell carcinoma increases the risk of mediastinal lymph node involvement by 195%, location central vs. peripheral by 68% and hilar node involvement by 166%.
The study demonstrates that izoSUV2.5 volume of primary tumor may be considered as a prognostic factor in NSCLC patients, since it strongly correlates with mediastinal lymph node pathological status. This correlation is modified by primary tumor location, histology and hilar node involvement.
本研究旨在确定基于正电子发射断层扫描-计算机断层扫描（PET-CT）测量的原发肿瘤体积在预测PET-CT显示N2阴性淋巴结的非小细胞肺癌（NSCLC）患者纵隔淋巴结转移（N2）方面的预后价值。
分析70例接受手术切除治疗的潜在可手术NSCLC患者的记录。所有患者均接受诊断性术前PET-CT检查，这是肿瘤体积计算以及N2淋巴结状态评估的基础。采用逻辑回归分析来确定纵隔淋巴结受累与原发肿瘤体积（izoSUV2.5体积，即SUV 2.5线内的原发肿瘤体积）、肿瘤组织学、位置（外周型与中央型）、肺门淋巴结状态之间的相关性。
发现纵隔淋巴结受累与izoSUV2.5体积、肿瘤组织学、外周型与中央型位置以及肺门淋巴结状态之间存在统计学显著相关性。肿瘤体积为100 cm³时，纵隔淋巴结转移风险为24%，肿瘤体积为360 cm³时，风险增加至40%。肿瘤体积每增加1 cm³，淋巴结疾病风险增加0.3%。肿瘤组织学腺癌与鳞状细胞癌相比，纵隔淋巴结受累风险增加195%，中央型与外周型位置相比增加68%，肺门淋巴结受累增加166%。
该研究表明，原发肿瘤的izoSUV2.5体积可被视为NSCLC患者的一个预后因素，因为它与纵隔淋巴结病理状态密切相关。这种相关性会因原发肿瘤位置、组织学和肺门淋巴结受累情况而改变。
