术后 PET/CT 代谢肿瘤负荷可预测胃癌患者的生存情况。
Metabolic tumor burden on postsurgical PET/CT predicts survival of patients with gastric cancer.
机构信息
Department of Nuclear Medicine, Changhai Hospital, Block 10, Changhai hospital, No. 168 in Changhai Road, Yangpu district, Shanghai, 200433, China.
出版信息
Cancer Imaging. 2019 Mar 22;19(1):18. doi: 10.1186/s40644-019-0205-9.
BACKGROUND
The prognostic value of postoperative F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) to patients with gastric cancer remains unclear. This study aims to investigate the prognostic value of whole body (WB) metabolic tumor burden (MTB) on postsurgical F-FDG PET/CT to patients with gastric cancer.
METHODS
A total of 376 patients with surgeries-confirmed gastric cancer were enrolled. Clinicopathologic information, overall survival (OS) and MTB parameters on postsurgical PET/CT, in terms of WB maximum standardized uptake value (SUV), WB metabolic tumor volume (MTV), and WB total lesion glycolysis (TLG) were collected. In-between differences of patient clinicopathologic characteristics, OS and MTB measurements were compared using chi-square test, Fisher's exact test, Student's t test or the Kaplan-Meier survival analysis. The optimal cutoffs of MTB measurements were calculated through the receiver operating characteristic (ROC) curve analysis. Univariable and multivariable Cox proportional hazard regression were performed to test the predictive value of the clinicopathologic factors and MTB measurements to patient survival.
RESULTS
The PET-positive patients had significantly decreased OS based on either Kaplan-Meier survival analysis (P < 0.001) or univariable Cox regression (hazard ratio [HR] = 2.850, P < 0.001). In patients with PET-positive tumors, the associations between OS and SUV, MTV and TLG were significant, both in univariable analysis (P < 0.001, P < 0.001 and P = 0.001, respectively) and in multivariable analysis (P = 0.002, P < 0.001 and P = 0.005, respectively). Patient OS among groups dichotomized by cutoffs of SUV > 8.6, MTV > 91.5 cm, and TLG > 477.6 cm were significantly different (P = 0.001, P < 0.001 and P = 0.001, respectively).
CONCLUSIONS
MTB, in terms of SUV, MTV and TLG, on postsurgical F-FDG PET/CT provides prognostic value to patients with gastric cancer after curative resection.
背景
术后 F-氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）对胃癌患者的预后价值仍不清楚。本研究旨在探讨胃癌患者术后全身（WB）代谢肿瘤负荷（MTB）对 F-FDG PET/CT 的预后价值。
方法
共纳入 376 例经手术证实的胃癌患者。收集术后 PET/CT 的临床病理信息、总生存期（OS）和 MTB 参数，包括 WB 最大标准化摄取值（SUV）、WB 代谢肿瘤体积（MTV）和 WB 总病灶糖酵解（TLG）。采用卡方检验、Fisher 确切检验、Student t 检验或 Kaplan-Meier 生存分析比较患者临床病理特征、OS 和 MTB 测量值之间的差异。通过受试者工作特征（ROC）曲线分析计算 MTB 测量的最佳截断值。采用单变量和多变量 Cox 比例风险回归分析测试临床病理因素和 MTB 测量值对患者生存的预测价值。
结果
基于 Kaplan-Meier 生存分析（P<0.001）或单变量 Cox 回归（风险比 [HR]=2.850，P<0.001），PET 阳性患者的 OS 显著降低。在 PET 阳性肿瘤患者中，OS 与 SUV、MTV 和 TLG 之间的相关性在单变量分析（P<0.001、P<0.001 和 P=0.001，分别）和多变量分析（P=0.002、P<0.001 和 P=0.005，分别）中均有显著意义。SUV>8.6、MTV>91.5cm 和 TLG>477.6cm 时 SUV、MTV 和 TLG 截断值分组的患者 OS 差异有统计学意义（P=0.001、P<0.001 和 P=0.001，分别）。
结论
术后 F-FDG PET/CT 的 MTB，包括 SUV、MTV 和 TLG，可为根治性切除术后的胃癌患者提供预后价值。
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