Wang Xiao-Yi, Zhao Yan-Feng, Liu Ying, Yang Yi-Kun, Wu Ning
Department of Diagnostic Radiology PET/CT Center Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2017 Sep;96(35):e7941. doi: 10.1097/MD.0000000000007941.
The objective of this study was to assess the prognostic value of metabolic tumor burden measured by positron emission tomography/computed tomography (PET/CT) in patients with stage I lung adenocarcinoma.We reviewed 127 consecutive patients with pathologically proven stage I lung adenocarcinoma who underwent pretreatment [18F]FDG PET/CT scans in our hospital from 2005 June to 2012 June. The maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography volume (CTV) were measured. The Kaplan-Meier and Cox proportional hazards model were used with age, gender, TNM stage, clinical stage, histological grade, nodule type, tumor size, and metabolic parameters to predict progression-free survival (PFS). The cut-off point was determined through receiver-operating characteristic curve.In univariate analysis, the histological grade, nodule type, diameter (cut-off value of 2.0 cm), CTV (6.56 cm), SUVmax (3.25 g/mL), SUVmean (1.58 g/mL), SUVpeak (1.84 g/mL), MTV (4.80 cm), and TLG (10.40) were significantly associated with PFS (all P value < .05). Patients with poorly differentiated adenocarcinoma, solid nodule type, large size, and high metabolic tumor burden were associated with poor prognosis. In multivariate analysis, only histological grade was independent prognostic factors for progression with a P value of .005 (RR, 0.355; 95% CI, 0.173-0.728). Among 5 PET/CT metabolic parameters, only MTV was independent prognostic factors for progression with a P value of .031 (RR, 1.118; 95% CI, 1.010-1.237).Histological grade was an independent predictor for progression in patients with stage I lung adenocarcinoma. Among 5 PET/CT metabolic parameters, only MTV was an independent predictor for progression.
本研究的目的是评估正电子发射断层扫描/计算机断层扫描（PET/CT）测量的代谢肿瘤负荷在Ⅰ期肺腺癌患者中的预后价值。我们回顾了2005年6月至2012年6月期间在我院接受预处理[18F]FDG PET/CT扫描的127例经病理证实为Ⅰ期肺腺癌的连续患者。测量了最大、平均和峰值标准化摄取值（SUVmax、SUVmean和SUVpeak）、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和计算机断层扫描体积（CTV）。采用Kaplan-Meier法和Cox比例风险模型，结合年龄、性别、TNM分期、临床分期、组织学分级、结节类型、肿瘤大小和代谢参数来预测无进展生存期（PFS）。通过受试者工作特征曲线确定截断点。单因素分析中，组织学分级、结节类型、直径（截断值为2.0 cm）、CTV（6.56 cm）、SUVmax（3.25 g/mL）、SUVmean（1.58 g/mL）、SUVpeak（1.84 g/mL）、MTV（4.80 cm）和TLG（10.40）与PFS显著相关（所有P值 < .05）。低分化腺癌、实性结节类型、大尺寸和高代谢肿瘤负荷的患者预后较差。多因素分析中，只有组织学分级是进展的独立预后因素，P值为.005（RR，0.355；95%CI，0.173 - 0.728）。在5个PET/CT代谢参数中，只有MTV是进展的独立预后因素，P值为.031（RR，1.118；95%CI，1.010 - 1.237）。组织学分级是Ⅰ期肺腺癌患者进展的独立预测因素。在5个PET/CT代谢参数中，只有MTV是进展的独立预测因素。
