代谢肿瘤体积和总病变糖酵解对术前 18F-FDG PET/CT 肾细胞癌患者的预后价值。

Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients With Renal Cell Carcinoma.

机构信息

From the *Departments of Diagnostic Imaging and Nuclear Medicine, and †Urology, Tokyo Women's Medical University, Tokyo, Japan.

出版信息

Clin Nucl Med. 2017 Apr;42(4):e177-e182. doi: 10.1097/RLU.0000000000001552.

DOI:10.1097/RLU.0000000000001552

PMID:28134692

Abstract

PURPOSE

We evaluated the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) measured using pretreatment F-FDG PET/CT in patients with renal cell carcinoma (RCC).

METHODS

A total of 139 patients with RCC who had undergone FDG PET/CT before tumor resection were retrospectively reviewed. We determined the SUVmax, MTV, and TLG and compared the results obtained with those required for a progression-free survival (PFS), which was defined as disease progression. Receiver operating characteristic curve analysis was used to compare prediction accuracies. Univariate and multivariate analyses of conventional clinicopathologic variables (age, sex, pathological tumor node metastasis [pTNM] stage, histological type, Fuhrman grade, and presence/absence of microscopic lymphatic and venous invasions) were used to compare the reliability of the metabolic parameters (SUVmax, MTV, and TLG).

RESULTS

Of the 139 patients, 24 patients (17%) experienced disease progression during the follow-up period. The age, pTNM stage, Fuhrman grade, presence/absence of microscopic lymphatic and venous invasions, SUVmax, MTV, and TLG were found to be significant prognostic factors for PFS (P < 0.05) on univariate analyses. Multivariate analyses revealed that MTV, TLG, and high pTNM stage (P = 0.02 [hazard ratio, 9.5; 95% confidence interval, 1.50-187.0], P = 0.02 [hazard ratio, 9.0; 95% confidence interval, 1.40-178.5], P = 0.004 [hazard ratio, 5.9; 95% confidence interval, 1.66-20.4], respectively) were the significant predictors after adjustment for other variables of PFS.

CONCLUSION

The pretreatment value of MTV, TLG, and high pTNM stage are the significant prognostic factors in patients with RCC.

摘要

目的

我们评估了使用预处理 F-FDG PET/CT 测量的代谢肿瘤体积（MTV）和总病变糖酵解（TLG）在肾细胞癌（RCC）患者中的预后价值。

方法

回顾性分析了 139 例在肿瘤切除前行 FDG PET/CT 检查的 RCC 患者。我们测定了 SUVmax、MTV 和 TLG，并将结果与无进展生存期（PFS）进行比较，PFS 定义为疾病进展。使用受试者工作特征曲线分析比较预测准确性。使用单变量和多变量分析传统临床病理变量（年龄、性别、病理肿瘤淋巴结转移 [pTNM] 分期、组织学类型、Fuhrman 分级以及有无镜下淋巴管和静脉侵犯）来比较代谢参数（SUVmax、MTV 和 TLG）的可靠性。

结果

在 139 例患者中，24 例（17%）在随访期间发生疾病进展。单因素分析显示，年龄、pTNM 分期、Fuhrman 分级、有无镜下淋巴管和静脉侵犯、SUVmax、MTV 和 TLG 是 PFS 的显著预后因素（P<0.05）。多变量分析显示，MTV、TLG 和高 pTNM 分期（P=0.02 [风险比，9.5；95%置信区间，1.50-187.0]、P=0.02 [风险比，9.0；95%置信区间，1.40-178.5]、P=0.004 [风险比，5.9；95%置信区间，1.66-20.4]）是调整 PFS 其他变量后的显著预测因素。