将 FDG PET 测量的 SUVmax 与中性粒细胞与淋巴细胞比值联合用于局部晚期非小细胞肺癌患者可改善临床结局预测。
Incorporation of the SUVmax Measured From FDG PET and Neutrophil-to-lymphocyte Ratio Improves Prediction of Clinical Outcomes in Patients With Locally Advanced Non-small-cell Lung Cancer.
机构信息
Weifang Medical University, Weifang, China.
Department of Radiotherapy, Qingdao Center Hospital, Qingdao, China.
出版信息
Clin Lung Cancer. 2019 Nov;20(6):412-419. doi: 10.1016/j.cllc.2019.06.008. Epub 2019 Jun 15.
INTRODUCTION
The aim of the present study was to investigate the value of incorporation 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) maximum standardized uptake value (SUVmax) and neutrophil-to-lymphocyte ratio (NLR) for improving prediction of clinical outcomes of patients with locally advanced non-small-cell lung cancer (LA NSCLC).
MATERIALS AND METHODS
We retrospectively enrolled 138 patients with unresectable LA NSCLC at our institution from July 2010 to August 2017. Spearman correlation analyses were used to estimate the correlations between SUVmax and NLR level. The univariate and multivariate Cox survival analyses were used to evaluate the prognostic indicators, including the incorporation of SUVmax and NLR. We defined the SUVmax and NLR grade (SNG = 0, 1, or 2) score as the number of risk factors among (1) SUVmax > 11.95 and (2) NLR > 3.82. The SNG score prognostic value was evaluated for overall survival (OS) and progression-free survival (PFS).
RESULTS
Univariate analysis showed that tumor stage, SUVmax, SUVmean, NLR, and SNG score were significantly associated with OS and PFS in patients with LA NSCLC. Kaplan-Meier analysis and log-rank test demonstrated significant differences in both OS and PFS among patients in SNG score (OS, P < .001; PFS, P < .001). Spearman correlation analyses showed that SUVmax had a correlation with the NLR (r = 0.237; P = .005). In subgroup analyses for patients with tumor pathologic stage IIIA/IIIB, we found that the SNG score was significantly associated with OS and PFS in each subgroup (P < .001, P < .001 for OS and P = .027, P < .001 for PFS, respectively). Multivariate analysis showed that the SNG score was a significantly independent prognostic factor for OS (hazard ratio, 1.612; 95% confidence interval, 1.157-2.246; P = .005) and PFS (hazard ratio, 2.241; 95% confidence interval, 1.486-3.379; P < .001).
CONCLUSION
Incorporation of the SUVmax and NLR improves prediction of clinical outcomes in patients with LA NSCLC.
简介
本研究旨在探讨纳入 18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）最大标准化摄取值（SUVmax）和中性粒细胞与淋巴细胞比值（NLR）对提高局部晚期非小细胞肺癌（LA NSCLC）患者临床结局预测的价值。
材料与方法
我们回顾性纳入了 2010 年 7 月至 2017 年 8 月在我院就诊的 138 例不可切除的 LA NSCLC 患者。采用 Spearman 相关分析来评估 SUVmax 与 NLR 水平之间的相关性。采用单因素和多因素 Cox 生存分析来评估包括 SUVmax 和 NLR 在内的预后指标。我们将 SUVmax 和 NLR 分级（SNG=0、1 或 2）定义为（1）SUVmax＞11.95 和（2）NLR＞3.82 这两个风险因素中的个数。我们评估了 SNG 评分对总生存期（OS）和无进展生存期（PFS）的预后价值。
结果
单因素分析显示，肿瘤分期、SUVmax、SUVmean、NLR 和 SNG 评分与 LA NSCLC 患者的 OS 和 PFS 显著相关。Kaplan-Meier 分析和对数秩检验表明，SNG 评分组的 OS 和 PFS 差异有统计学意义（OS，P＜0.001；PFS，P＜0.001）。Spearman 相关分析显示，SUVmax 与 NLR 相关（r=0.237；P=0.005）。在肿瘤病理分期为 IIIA/IIIB 的患者亚组分析中，我们发现 SNG 评分与 OS 和 PFS 均显著相关（OS，P＜0.001；PFS，P=0.027；P＜0.001）。多因素分析显示，SNG 评分是 OS（危险比，1.612；95%置信区间，1.157-2.246；P=0.005）和 PFS（危险比，2.241；95%置信区间，1.486-3.379；P＜0.001）的显著独立预后因素。
结论
SUVmax 和 NLR 的纳入提高了 LA NSCLC 患者临床结局的预测能力。
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