Lee Jeong Won, Baek Moo-Jun, Ahn Tae Sung, Lee Sang Mi
Department of Nuclear Medicine.
Institue for Integrative Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon.
Eur J Gastroenterol Hepatol. 2018 Feb;30(2):187-194. doi: 10.1097/MEG.0000000000001018.
This study investigated the relationship of fluorine-18-fluorodeoxyglucose (F-FDG) uptake of bone marrow (BM) on PET/computed tomography (PET/CT) with clinicopathologic factors and survival in patients with colorectal cancer.
The study retrospectively included 226 patients with colorectal cancer who underwent F-FDG PET/CT for staging workup and treated with curative surgical resection. The maximum F-FDG uptake of primary cancer (Tmax) and mean F-FDG uptake of BM [BM standardized uptake value (SUV)] were derived from PET/CT images. The relationships between BM SUV and clinicopathologic factors and prognostic value of BM SUV for predicting recurrence-free survival (RFS) were assessed.
Patients with T3-T4 stage and hepatic metastases had significantly higher values of BM SUV than those with T1-T2 stage and no distant metastases (P<0.05). BM SUV showed significant positive correlation with Tmax, tumor size, serum C-reactive protein level, white blood cell count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (P<0.05). Univariate survival analysis revealed that N stage, M stage, tumor involvement of resection margin, lymphatic invasion, and BM SUV were significant predictors for RFS (P<0.05), whereas Tmax failed to show significance. In multivariate analysis, N stage (P=0.012 for N1 stage and P=0.020 for N2 stage), tumor involvement of resection margin (P=0.009), and BM SUV (P=0.005) were significantly associated with RFS.
Increased BM SUV was observed in patients with advanced stage and increased serum inflammatory markers. BM SUV was an independent predictor for RFS in colorectal cancer.
本研究探讨正电子发射断层显像/计算机断层扫描（PET/CT）中骨髓（BM）的氟-18-氟脱氧葡萄糖（F-FDG）摄取与结直肠癌患者临床病理因素及生存情况之间的关系。
本研究回顾性纳入了226例接受F-FDG PET/CT进行分期检查并接受根治性手术切除治疗的结直肠癌患者。原发癌的最大F-FDG摄取量（Tmax）和BM的平均F-FDG摄取量[BM标准化摄取值（SUV）]均来自PET/CT图像。评估了BM SUV与临床病理因素之间的关系以及BM SUV对预测无复发生存期（RFS）的预后价值。
T3 - T4期和有肝转移的患者BM SUV值显著高于T1 - T2期且无远处转移的患者（P<0.05）。BM SUV与Tmax、肿瘤大小、血清C反应蛋白水平、白细胞计数、中性粒细胞与淋巴细胞比值以及血小板与淋巴细胞比值呈显著正相关（P<0.05）。单因素生存分析显示，N分期、M分期、手术切缘肿瘤累及情况、淋巴管浸润和BM SUV是RFS的显著预测因素（P<0.05），而Tmax未显示出显著性。多因素分析中，N分期（N1期P = 0.012，N2期P = 0.020）、手术切缘肿瘤累及情况（P = 0.009）和BM SUV（P = 0.005）与RFS显著相关。
晚期患者以及血清炎症标志物升高的患者中观察到BM SUV升高。BM SUV是结直肠癌RFS的独立预测因素。
