Jeon Hyun Woo, Kim Kyung Soo, Sung Sook Whan, Park Hyung Joo, Kim Young-Du, Park Jae Kil
Department of Thoracic and Cardiovascular Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Thorac Cardiovasc Surg. 2015 Jun;63(4):341-8. doi: 10.1055/s-0034-1384787. Epub 2014 Oct 16.
Esophageal cancer is a malignant tumor with one of the worst prognosis. Positron emission tomography (PET) reveals the degree of metabolic activity of tumor cells. We hypothesized that a high maximum standardized uptake value (SUVmax) on PET would predict a poor clinical outcome.
From November 2004 to August 2011, we reviewed 88 patients with esophageal squamous cell carcinoma who underwent preoperative PET followed by surgery. SUVmax values of primary sites were measured. The patients were divided into two groups with median SUVmax as a cutoff value and outcomes were compared.
The median SUVmax was 6.35. Cervical and upper thoracic cancer, large tumor size, stage ≥ T2, and lymph node metastasis were significantly associated with the high SUVmax group. Cervical and upper thoracic cancer (p = 0.038), SUVmax (p = 0.038), number of lymph nodes dissected (p = 0.009), stage ≥ T2 (p = 0.003), lymph node metastasis (p < 0.001), and incomplete resection (p = 0.031) were significant predictors for the disease-free survival. A high SUVmax ( ≥ 6.35, p = 0.023) and stage ≥ T2 (p = 0.025) were significantly associated with overall survival by multivariate analysis.
High preoperative SUVmax on PET predicts advanced T stage and worse prognosis. SUVmax on PET may provide useful information combined with current stage for determining optimal treatment in esophageal cancer.
食管癌是一种预后最差的恶性肿瘤之一。正电子发射断层扫描（PET）可揭示肿瘤细胞的代谢活性程度。我们假设PET上的高最大标准化摄取值（SUVmax）可预测不良的临床结局。
2004年11月至2011年8月，我们回顾了88例接受术前PET检查后行手术的食管鳞状细胞癌患者。测量原发部位的SUVmax值。以SUVmax的中位数作为临界值将患者分为两组，并比较其结局。
SUVmax的中位数为6.35。颈段和胸上段癌、肿瘤体积大、分期≥T2以及淋巴结转移与高SUVmax组显著相关。颈段和胸上段癌（p = 0.038）、SUVmax（p = 0.038）、清扫淋巴结数量（p = 0.009）、分期≥T2（p = 0.003）、淋巴结转移（p < 0.001）以及切除不完全（p = 0.031）是无病生存的显著预测因素。多因素分析显示，高SUVmax（≥6.35，p = 0.023）和分期≥T2（p = 0.025）与总生存显著相关。
术前PET上的高SUVmax预示着T分期进展和预后较差。PET上的SUVmax可能与当前分期相结合，为确定食管癌的最佳治疗方案提供有用信息。
