Hasbek Zekiye, Yucel Birsen, Salk Ismail, Turgut Bulent, Erselcan Taner, Babacan Nalan Akgul, Kacan Turgut
Department of Nuclear Medicine, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey E-mail :
Asian Pac J Cancer Prev. 2014;15(9):4085-9. doi: 10.7314/apjcp.2014.15.9.4085.
Atelectasis is an important prognostic factor that can cause pleuritic chest pain, coughing or dyspnea, and even may be a cause of death. In this study, we aimed to investigate the potential impact of atelectasis and PET parameters on survival and the relation between atelectasis and PET parameters.
The study consisted of patients with lung cancer with or without atelectasis who underwent (18)F-FDG PET/CT examination before receiving any treatment. (18)F-FDG PET/CT derived parameters including tumor size, SUVmax, SUVmean, MTV, total lesion glycosis (TLG), SUV mean of atelectasis area, atelectasis volume, and histological and TNM stage were considered as potential prognostic factors for overall survival.
Fifty consecutive lung cancer patients (22 patients with atelectasis and 28 patients without atelectasis, median age of 65 years) were evaluated in the present study. There was no relationship between tumor size and presence or absence of atelectasis, nor between presence/absence of atelectasis and TLG of primary tumors. The overall one-year survival rate was 83% and median survival was 20 months (n=22) in the presence of atelectasis; the overall one-year survival rate was 65.7% (n=28) and median survival was 16 months (p=0.138) in the absence of atelectasis. With respect to PFS; the one-year survival rate of AT+ patients was 81.8% and median survival was 19 months; the one-year survival rate of AT- patients was 64.3% and median survival was 16 months (p=0.159). According to univariate analysis, MTV, TLG and tumor size were significant risk factors for PFS and OS (p<0.05). However, SUVmax was not a significant factor for PFS and OS (p>0.05).
The present study suggested that total lesion glycolysis and metabolic tumor volume were important predictors of survival in lung cancer patients, in contrast to SUVmax. In addition, having a segmental lung atelectasis seems not to be a significant factor on survival.
肺不张是一个重要的预后因素，可导致胸膜炎性胸痛、咳嗽或呼吸困难，甚至可能是死亡原因。在本研究中，我们旨在探讨肺不张和PET参数对生存的潜在影响以及肺不张与PET参数之间的关系。
本研究纳入了在接受任何治疗前接受（18）F-FDG PET/CT检查的伴有或不伴有肺不张的肺癌患者。（18）F-FDG PET/CT得出的参数，包括肿瘤大小、SUVmax、SUVmean、MTV、总病变糖酵解（TLG）、肺不张区域的SUV均值、肺不张体积以及组织学和TNM分期，被视为总生存的潜在预后因素。
本研究共评估了50例连续的肺癌患者（22例伴有肺不张，28例不伴有肺不张，中位年龄65岁）。肿瘤大小与肺不张的有无之间、肺不张的有无与原发肿瘤的TLG之间均无关联。存在肺不张时，总体一年生存率为83%，中位生存期为20个月（n = 22）；不存在肺不张时，总体一年生存率为65.7%（n = 28），中位生存期为16个月（p = 0.138）。关于无进展生存期（PFS）；伴有肺不张患者的一年生存率为81.8%，中位生存期为19个月；不伴有肺不张患者的一年生存率为64.3%，中位生存期为16个月（p = 0.159）。单因素分析显示，MTV、TLG和肿瘤大小是PFS和总生存期（OS）的显著危险因素（p < 0.05）。然而，SUVmax不是PFS和OS的显著因素（p > 0.05）。
本研究表明，与SUVmax不同，总病变糖酵解和代谢肿瘤体积是肺癌患者生存的重要预测因素。此外，存在节段性肺不张似乎不是影响生存的显著因素。
