Yoon Joon-Kee, Byun Cheulsu, Jo Kyung Sook, Hur Hun, Lee Kee Myung, Lim Seon Kyo, Lee Dakeun, Lee Su Jin, An Young-Sil, Han Sang-Uk
Department of Nuclear Medicine and Molecular Imaging.
Department of Surgery.
Medicine (Baltimore). 2019 Aug;98(31):e16690. doi: 10.1097/MD.0000000000016690.
This study investigated the clinicopathologic factors associated with 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) uptake of early gastric cancer (EGC) and used them to design a clinical scoring method to predict FDG-avidity of EGC.Two hundred twenty-nine retrospectively enrolled patients underwent preoperative F-FDG positron emission tomography/computed tomography (PET/CT). Histologic information was obtained by gastrectomy (n = 195) or endoscopic mucosal dissection (n = 34). The association between clinicopathologic factors and F-FDG uptake by the primary tumor was determined. The results were used to develop a clinical scoring method.F-FDG uptake was detected in 49 (17.5%) patients. According to univariate analysis, location, gross type, World Health Organization classification, Lauren classification, size, depth of invasion, and lymphatic invasion were significant variables affecting F-FDG uptake (all P < .05). According to multivariate analysis, location (lower 3rd, P = .035), gross type (0-I, 0-IIa, P < .001), size (≥2.5 cm, P = .026), and depth of invasion (submucosa, P = .007) were significantly associated with FDG-avidity. A clinical scoring system, ranged from 0 to 4, was developed by giving one score to 4 independent variables. A cut-off value of 2.5 showed good prediction of FDG-avidity in EGCs, with a sensitivity and specificity of 65.0% and 85.2%, respectively.F-FDG uptake by EGC depends on location, gross type, size, and depth of invasion of the primary tumor. A clinical scoring system based on clinicopathologic variables can predict the FDG-avidity of primary tumors in patients with EGC.
本研究调查了与早期胃癌（EGC）的2-[F]氟-2-脱氧-D-葡萄糖（F-FDG）摄取相关的临床病理因素，并利用这些因素设计了一种临床评分方法来预测EGC的FDG摄取活性。229例回顾性纳入的患者接受了术前F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）。通过胃切除术（n = 195）或内镜黏膜下剥离术（n = 34）获得组织学信息。确定了临床病理因素与原发肿瘤F-FDG摄取之间的关联。结果用于开发一种临床评分方法。49例（17.5%）患者检测到F-FDG摄取。单因素分析显示，部位、大体类型、世界卫生组织分类、劳伦分类、大小、浸润深度和淋巴浸润是影响F-FDG摄取的显著变量（均P<0.05）。多因素分析显示，部位（胃下1/3，P = 0.035）、大体类型（0-I型、0-IIa型，P<0.001）、大小（≥2.5 cm，P = 0.026）和浸润深度（黏膜下层，P = 0.007）与FDG摄取活性显著相关。通过对4个独立变量各赋予1分，开发了一个范围为0至4分的临床评分系统。截断值为2.5时对EGC的FDG摄取活性具有良好的预测能力，敏感性和特异性分别为65.0%和85.2%。EGC的F-FDG摄取取决于原发肿瘤的部位、大体类型、大小和浸润深度。基于临床病理变量的临床评分系统可预测EGC患者原发肿瘤的FDG摄取活性。
