F-氟脱氧葡萄糖PET参数及炎症在鼻咽癌患者中的预后价值
Prognostic value of F-fluorodeoxyglucose PET parameters and inflammation in patients with nasopharyngeal carcinoma.
作者信息
Zhong Liting, Li Chunming, Ren Yunyan, Wu Dehua
机构信息
Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.
Department of Oncology, Jiangmen Central Hospital, Jiangmen, Guangdong 529000, P.R. China.
出版信息
Oncol Lett. 2017 Oct;14(4):5004-5012. doi: 10.3892/ol.2017.6816. Epub 2017 Aug 24.
The aim of the present study was to investigate the association between positron emission tomography (PET) parameters and peripheral inflammatory markers, and assess their prognostic value in nasopharyngeal carcinoma (NPC). A total of 121 patients with non-disseminated NPC were recruited. Pretreatment maximum standardized uptake values (SUVmax) of PET and peripheral inflammatory factors (leukocyte, neutrophil and monocyte counts) were recorded. Kaplan-Meier and multivariate analyses were used to identify predictors for progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS). The results of the present study revealed that SUVmax at the primary tumor was positively correlated with leukocytes (P=0.025), neutrophils (P=0.009) and monocytes (P=0.043). SUVmax at regional lymph nodes (SUVmax-N) was significantly associated with monocytes (P=0.024). Kaplan-Meier analysis demonstrated that SUVmax-N (>10.15) significantly predicted PFS (P=0.004) and DMFS (P=0.003). In addition, neutrophils (>5.18) were significantly associated with PFS (P=0.001), DMFS (P=0.013) and LRFS (P<0.001). Multivariate analysis revealed that SUVmax-N and neutrophils retained independent prognostic significance for PFS (SUVmax-N, P=0.026; and neutrophils, P=0.033) and DMFS (SUVmax-N, P=0.026; and neutrophils, P=0.032). Furthermore, patients with SUVmax-N ≤10.15 and neutrophils ≤5.18 had significantly improved prognosis in PFS (96.4 vs. 58.5%, P<0.001), OS (95.7 vs. 81.1%, P=0.044), DMFS (96.4 vs. 67.0%, P<0.001) and LRFS (100 vs. 90.2%, P=0.036) compared with those with SUVmax-N >10.15 or neutrophils >5.18. In conclusion, SUVmax may be significantly associated with cancer-associated inflammation. SUVmax-N and neutrophils were independent prognostic indicators for PFS and DMFS. Combined assessment of SUVmax-N and neutrophils may lead to refinement of risk stratification in NPC.
本研究旨在探讨正电子发射断层扫描（PET）参数与外周炎症标志物之间的关联，并评估它们在鼻咽癌（NPC）中的预后价值。共招募了121例未发生转移的NPC患者。记录PET的治疗前最大标准化摄取值（SUVmax）和外周炎症因子（白细胞、中性粒细胞和单核细胞计数）。采用Kaplan-Meier分析和多变量分析来确定无进展生存期（PFS）、总生存期（OS）、无远处转移生存期（DMFS）和无局部区域复发生存期（LRFS）的预测因素。本研究结果显示，原发肿瘤处的SUVmax与白细胞（P = 0.025）、中性粒细胞（P = 0.009）和单核细胞（P = 0.043）呈正相关。区域淋巴结处的SUVmax（SUVmax-N）与单核细胞显著相关（P = 0.024）。Kaplan-Meier分析表明，SUVmax-N（>10.15）显著预测PFS（P = 0.004）和DMFS（P = 0.003）。此外，中性粒细胞（>5.18）与PFS（P = 0.001）、DMFS（P = 0.013）和LRFS（P<0.001）显著相关。多变量分析显示，SUVmax-N和中性粒细胞对PFS（SUVmax-N，P = 0.026；中性粒细胞，P = 0.033）和DMFS（SUVmax-N，P = 0.026；中性粒细胞，P = 0.032）保留独立的预后意义。此外，与SUVmax-N>10.15或中性粒细胞>5.18的患者相比，SUVmax-N≤10.15且中性粒细胞≤5.18的患者在PFS（96.4%对58.5%，P<0.001）、OS（95.7%对81.1%，P = 0.044）、DMFS（96.4%对67.0%，P<0.001）和LRFS（100%对90.2%，P = 0.036）方面预后显著改善。总之，SUVmax可能与癌症相关炎症显著相关。SUVmax-N和中性粒细胞是PFS和DMFS的独立预后指标。联合评估SUVmax-N和中性粒细胞可能会优化NPC的风险分层。
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