Pimiento Jose M, Davis-Yadley Ashley H, Kim Richard D, Chen Dung-Tsa, Eikman Edward A, Berman Claudia G, Malafa Mokenge P
From the *Surgical Oncology, H. Lee Moffitt Cancer Center and Research Institute; and †Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL.
Clin Nucl Med. 2016 Mar;41(3):177-81. doi: 10.1097/RLU.0000000000001098.
Metabolic activity, as defined by F-FDG uptake on PET, is a prognostic marker for multiple malignancies; however, no study has examined the prognostic value of imaging with FDG PET in stage I and II pancreatic cancer. We examined the value of PET FDG uptake in early-stage pancreatic cancer patients.
We identified patients with early-stage pancreatic cancer (I-II) who had FDG PET scan performed as part of their preoperative evaluation. The patients were divided into either high or low FDG uptake according to the median primary tumor standard uptake value (SUVmax). Our primary end points were overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier estimate was used for survival analysis. Pathologic data were compared using the Fisher exact and χ tests.
One hundred five patients were identified: 51 patients with low FDG uptake and 54 patients with high FDG uptake. Eighty-five patients (81%) had PET avid tumors, whereas 20 (19%) patients did not. High FDG uptake correlated with pathologic stage (P = 0.012). Patients with low FDG uptake had significantly better median OS than patients with high FDG uptake (28 vs. 16 months; P = 0.036). Patients with low-FDG uptake had significantly longer median RFS than patients with high FDG uptake (14 vs. 12 months; P = 0.049).
Low FDG uptake in PET scans in patients with stage I and II pancreatic cancer correlates with improved OS and RFS. This supports the concept that glucose metabolic pathways are important in pancreatic cancer biology and that PET scan activity can be used as a prognostic biomarker after pancreatectomy.
正电子发射断层扫描（PET）上通过氟代脱氧葡萄糖（F-FDG）摄取所定义的代谢活性是多种恶性肿瘤的预后标志物；然而，尚无研究探讨FDG PET成像在Ⅰ期和Ⅱ期胰腺癌中的预后价值。我们研究了PET FDG摄取在早期胰腺癌患者中的价值。
我们纳入了在术前评估中进行了FDG PET扫描的早期胰腺癌（Ⅰ-Ⅱ期）患者。根据原发肿瘤最大标准摄取值（SUVmax）的中位数，将患者分为FDG摄取高或低两组。我们的主要终点是总生存期（OS）和无复发生存期（RFS）。采用Kaplan-Meier估计法进行生存分析。使用Fisher精确检验和χ检验比较病理数据。
共纳入105例患者：51例FDG摄取低，54例FDG摄取高。85例患者（81%）的肿瘤对PET呈高摄取，而20例患者（19%）不呈高摄取。FDG高摄取与病理分期相关（P = 0.012）。FDG摄取低的患者的中位OS显著优于FDG摄取高的患者（28个月对16个月；P = 0.036）。FDG摄取低的患者的中位RFS显著长于FDG摄取高的患者（14个月对12个月；P = 0.049）。
Ⅰ期和Ⅱ期胰腺癌患者PET扫描中FDG摄取低与OS和RFS改善相关。这支持了葡萄糖代谢途径在胰腺癌生物学中很重要的概念，并且PET扫描活性可作为胰腺切除术后的预后生物标志物。
