Liang Ying, Li Xiaomeng, Wan Huan, Fang Yan, Zheng Rong, Zhang Wenjie, Liu Ying, Chen Cong, Wu Ning
From the PET/CT Center, Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
J Comput Assist Tomogr. 2018 May/Jun;42(3):429-434. doi: 10.1097/RCT.0000000000000708.
The aim of the study was to assess the prognostic impact of volume-based metabolic F-fluorodeoxyglucose-positron emission tomography/ computed tomography (F-FDG-PET/CT) parameters in patients with stage IB-IVA squamous cell cervical carcinoma (SCCC).
We reviewed the pretreatment F-FDG-PET/CT records of 67 patients with stage IB-IVA SCCC. The maximum standardized uptake value (SUVmax) of the primary tumor (PSUVmax), highest SUVmax of the whole malignant lesions (WSUVmax), metabolic tumor volume (MTV) of the primary tumor (PMTV), MTV of the whole malignant lesion (WMTV), total lesion glycolysis (TLG) of primary tumor (PTLG), and TLG of the whole malignant lesion (WTLG) were obtained. Univariate and multivariate analyses were performed to assess the predictive values of metabolic parameters.
Twenty-nine patients showed disease progression and 21 patients died during follow-up. In univariate analysis, positive lymph node, WSUVmax of greater than 11, WMTV of greater than 63 cm, and WTLG of greater than 373 adversely affected the progression-free survival (P = 0.004, 0.045, 0.023, and 0.005, respectively). A positive lymph node, WSUVmax of greater than 12, WMTV of greater than 68 cm, and WTLG of greater than 373 significantly adversely affected overall survival (P = 0.002, 0.032, 0.015, and 0.006, respectively). In multivariate analysis, independent prognostic factor for progression-free survival was WTLG (relative risk = 2.384, 95% confidence interval = 1.095-5.187, P = 0.029). Independent prognostic factors for overall survival was WTLG (relative risk = 2.763; 95% confidence interval = 1.107-6.896, P = 0.029).
Preliminary results indicated that pretreatment WTLG measured by F-FDG-PET/CT could independently predict survival in patients with locally advanced SCCC.
本研究旨在评估基于体积的代谢氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG-PET/CT）参数对IB-IVA期宫颈鳞状细胞癌（SCCC）患者的预后影响。
我们回顾了67例IB-IVA期SCCC患者的治疗前F-FDG-PET/CT记录。获取原发肿瘤的最大标准化摄取值（SUVmax）（PSUVmax）、全部恶性病变的最高SUVmax（WSUVmax）、原发肿瘤的代谢肿瘤体积（MTV）（PMTV）、全部恶性病变的MTV（WMTV）、原发肿瘤的总病变糖酵解（TLG）（PTLG）以及全部恶性病变的TLG（WTLG）。进行单因素和多因素分析以评估代谢参数的预测价值。
29例患者在随访期间出现疾病进展，21例患者死亡。在单因素分析中，阳性淋巴结、WSUVmax大于11、WMTV大于63 cm以及WTLG大于373对无进展生存期有不利影响（P分别为0.004、0.045、0.023和0.005）。阳性淋巴结、WSUVmax大于12、WMTV大于68 cm以及WTLG大于373对总生存期有显著不利影响（P分别为0.002、0.032、0.015和0.006）。在多因素分析中，无进展生存期的独立预后因素是WTLG（相对风险=2.384，95%置信区间=1.095 - 5.187，P = 0.029）。总生存期的独立预后因素是WTLG（相对风险=2.763；95%置信区间=1.107 - 6.896，P = 0.029）。
初步结果表明，F-FDG-PET/CT测量的治疗前WTLG可独立预测局部晚期SCCC患者的生存情况。
