Satoh Kei, Patel Dhaval, Dieckmann William, Nilubol Naris, Kebebew Electron
Endocrine Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Ann Surg Oncol. 2015 Dec;22 Suppl 3:S714-20. doi: 10.1245/s10434-015-4813-8. Epub 2015 Aug 18.
Adrenocortical carcinoma (ACC) is a rare but lethal malignancy with few reliable prognostic markers. FDG-PET metabolic parameters have been shown to predict survival in several cancers. The objective was to determine if metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) could serve as prognostic markers in patients with ACC.
A total of 30 patients with ACC prospectively underwent 18F-FDG PET/CT prior to treatment. Whole body MTV, TLG, and SUVmax were measured by a semiautomatic method. A median cutoff was used to determine an association with overall survival (OS) from the time of 18F-FDG PET/CT by the Kaplan-Meier method.
Patients with high whole body MTV (>87.0 mL),TLG (>229.4 SUVlbmmL), or SUVmax (>8.9 SUV) had a worse OS compared with those with low whole body MTV (median OS, 24 vs 45.1 months, p < .01), TLG (median OS, 24 vs 40.3 months, p < .005), or SUVmax (median OS, 23.7 vs 35.5 months, p < .02). In patients who had operable disease (n = 23), high whole body MTV (>87.0 mL) and TLG (>229.4 SUVlbmmL) had a worse OS compared with those with low whole body MTV (median OS, 25.1 vs 45.1 months, p < .05) and TLG (median OS, 25.1 vs 40.3 months, p < .05), but a high SUVmax (>8.9 SUV) was not associated with worse OS (p = .11).
Patients with ACC and a high whole body MTV, TLG, and SUVmax have a worse prognosis and OS. Measurement of whole body MTV and TLG may be helpful for guiding therapy for patients with ACC.
肾上腺皮质癌（ACC）是一种罕见但致命的恶性肿瘤，几乎没有可靠的预后标志物。FDG-PET代谢参数已被证明可预测多种癌症的生存率。目的是确定代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和最大标准化摄取值（SUVmax）是否可作为ACC患者的预后标志物。
共有30例ACC患者在治疗前前瞻性地接受了18F-FDG PET/CT检查。采用半自动方法测量全身MTV、TLG和SUVmax。通过Kaplan-Meier方法，使用中位数截断值来确定与自18F-FDG PET/CT检查时起的总生存期（OS）的相关性。
全身MTV高（>87.0 mL）、TLG高（>229.4 SUVlbmmL）或SUVmax高（>8.9 SUV）的患者与全身MTV低的患者相比，OS更差（中位OS，24个月对45.1个月，p <.01）、TLG低的患者（中位OS，24个月对40.3个月，p <.005）或SUVmax低的患者（中位OS，23.7个月对35.5个月，p <.02）。在患有可手术疾病的患者（n = 23）中，全身MTV高（>87.0 mL）和TLG高（>229.4 SUVlbmmL）的患者与全身MTV低的患者相比，OS更差（中位OS，25.1个月对45.1个月，p <.05）和TLG低的患者（中位OS，25.1个月对40.3个月，p <.05），但SUVmax高（>8.9 SUV）与较差的OS无关（p =.11）。
ACC患者全身MTV、TLG和SUVmax高者预后和OS较差。测量全身MTV和TLG可能有助于指导ACC患者的治疗。
