Sun Yuyun, Liu Shuai, Feng Zheng, Cheng Jingyi, Lu Linjun, Wang Mingwei, Yuan Huiyu, Xu Junyan, Zhang Yingjian
Departments of Nuclear Medicine.
Center for Biomedical Imaging.
Nucl Med Commun. 2018 Aug;39(8):761-767. doi: 10.1097/MNM.0000000000000865.
The aim of this study was to explore the clinical and prognostic implication of preoperative fluorine-18-fluorodeoxyglucose uptake value of omental metastasis-related in advanced high-grade serous ovarian cancer patients (HGSC).
We retrospectively investigated HGSC patients with omental metastasis (International Federation of Gynecology and Obstetrics stage IIIB-IV) who underwent PET/CT before primary surgery in our hospital between January 2010 and January 2016. All patients were confirmed omental metastasis by postoperative pathology. None of these patients received neoadjuvant chemotherapy. PET/CT parameters, including maximum standardized uptake value of primary ovary tumor (SUVp), omental metastasis (SUVo), and omental metastasis-to-primary tumor (SUVo/p) were measured. The relationships between PET/CT parameters and clinical characteristics were analyzed by t-test. Kaplan-Meier methods and log-rank tests were used to analyze progression-free survival (PFS) in univariate analysis. For multivariate analysis, COX regression analysis was used to assess the prognostic predictive value of PET/CT-derived variables.
Totally 81 advanced HGSC patients with omental metastasis were enrolled in our study, and 49 (60.5%) patients experienced recurrence and disease progression. The median (range) follow-up time was 18.5 (7-72) months. Older patients showed higher level of SUVo/p (P=0.006). Chemosensitive patients had lower levels of SUVo (P=0.009) and SUVo/p (P<0.001) than those chemoresistant ones. In univariate analysis, patients with better PFS were associated with lower SUVo (P<0.001) and SUVo/p (P<0.001). Multivariate analysis found only SUVo/p was an independent factor for PFS (P=0.006).
Preoperative SUVo/p measured by fluorine-18-fluorodeoxyglucose PET/CT appeared to be an independent predictive factor for recurrence in advanced HGSC patients. Chemosensitive patients had lower omentum-related SUV values than those chemoresistant ones.
本研究旨在探讨晚期高级别浆液性卵巢癌（HGSC）患者术前与大网膜转移相关的氟-18-氟脱氧葡萄糖摄取值的临床及预后意义。
我们回顾性研究了2010年1月至2016年1月期间在我院接受初次手术前进行PET/CT检查的伴有大网膜转移的HGSC患者（国际妇产科联盟分期IIIB-IV期）。所有患者均经术后病理证实有大网膜转移。这些患者均未接受新辅助化疗。测量PET/CT参数，包括原发性卵巢肿瘤的最大标准化摄取值（SUVp）、大网膜转移灶（SUVo）以及大网膜转移灶与原发性肿瘤的比值（SUVo/p）。通过t检验分析PET/CT参数与临床特征之间的关系。采用Kaplan-Meier法和对数秩检验进行单因素分析中的无进展生存期（PFS）分析。多因素分析采用COX回归分析评估PET/CT衍生变量的预后预测价值。
本研究共纳入81例伴有大网膜转移的晚期HGSC患者，其中49例（60.5%）患者出现复发和疾病进展。中位（范围）随访时间为18.5（7 - 72）个月。年龄较大的患者SUVo/p水平较高（P = 0.006）。化疗敏感患者的SUVo（P = 0.009）和SUVo/p（P < 0.001）水平低于化疗耐药患者。单因素分析中，PFS较好的患者与较低的SUVo（P < 0.001）和SUVo/p（P < 0.001）相关。多因素分析发现只有SUVo/p是PFS的独立因素（P = 0.006）。
氟-18-氟脱氧葡萄糖PET/CT测量的术前SUVo/p似乎是晚期HGSC患者复发的独立预测因素。化疗敏感患者的大网膜相关SUV值低于化疗耐药患者。
