Kaira Kyoichi, Yamamoto Nobuyuki, Kenmotsu Hirotsugu, Murakami Haruyasu, Ono Akira, Naito Tateaki, Endo Masahiro, Takahashi Toshiaki
Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan.
Respir Investig. 2014 Mar;52(2):121-8. doi: 10.1016/j.resinv.2013.08.008. Epub 2013 Oct 24.
Whether fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake within tumor cells differs between primary and recurrent lung cancers is unknown. The aim of this study was to investigate the prognostic significance of (18)F-FDG uptake by comparing that measured preoperatively at the primary site to that measured postoperatively at sites of non-small cell lung cancer (NSCLC) recurrence. Only patients with postoperative recurrences who received platinum-based chemotherapy as the initial treatment after recurrence were included in the study.
Fifty-two patients underwent (18)F-FDG positron emission tomography (PET) examinations before thoracotomy and at the time of recurrence after curative surgery. All recurrences were treated with platinum-based chemotherapy.
(18)F-FDG uptake in the preoperative primary tumors was significantly higher than that in the recurrent tumors (p=0.028), demonstrating a statistically significant correlation (Pearson's correlation coefficient γ=0.482, p<0.001), especially in adenocarcinoma (AC) patients. Low (18)F-FDG avidity within the primary tumor significantly correlated with the presence of epidermal growth receptor factor (EGFR) mutations. (18)F-FDG uptake in the primary tumors was an independent prognostic factor for predicting outcome in NSCLC patients receiving platinum-based chemotherapy for the treatment of postoperative recurrence.
In NSCLC patients treated by chemotherapy for recurrence, preoperative measurements of (18)F-FDG uptake may be a more powerful surrogate marker for predicting outcome when measured preoperatively at the primary tumor site rather than postoperatively at sites of recurrence.
肿瘤细胞内氟-18-氟脱氧葡萄糖（(18)F-FDG）摄取在原发性和复发性肺癌之间是否存在差异尚不清楚。本研究的目的是通过比较术前在原发部位测量的(18)F-FDG摄取与术后在非小细胞肺癌（NSCLC）复发部位测量的(18)F-FDG摄取，来研究其预后意义。本研究仅纳入复发后接受铂类化疗作为初始治疗的术后复发患者。
52例患者在开胸手术前及根治性手术后复发时接受了(18)F-FDG正电子发射断层扫描（PET）检查。所有复发均接受铂类化疗。
术前原发肿瘤中的(18)F-FDG摄取显著高于复发肿瘤（p=0.028），显示出统计学上的显著相关性（Pearson相关系数γ=0.482，p<0.001），尤其是在腺癌（AC）患者中。原发肿瘤内低(18)F-FDG亲和力与表皮生长受体因子（EGFR）突变的存在显著相关。原发肿瘤中的(18)F-FDG摄取是预测接受铂类化疗治疗术后复发的NSCLC患者预后的独立预后因素。
在接受化疗治疗复发的NSCLC患者中，术前在原发肿瘤部位测量(18)F-FDG摄取可能比术后在复发部位测量更能有力地预测预后。
