Lee Jeong Won, Ban Myung Jin, Park Jae Hong, Lee Sang Mi
Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon 22711, Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea.
J Clin Med. 2019 Aug 4;8(8):1169. doi: 10.3390/jcm8081169.
The purpose of this study was to assess the relationship between F-18 fluorodeoxyglucose (FDG) uptake in bone marrow (BM) on positron emission tomography/computed tomography (PET/CT) and survival in patients with head and neck squamous cell carcinoma (HNSCC). We retrospectively enrolled 157 HNSCC patients who underwent staging FDG PET/CT and subsequent treatment. On PET/CT, primary tumor metabolic characteristics, mean FDG uptake of BM (BM SUV), and BM-to-liver uptake ratio (BLR) were measured. The prognostic significance of FDG uptake of BM for predicting disease progression-free survival and distant failure-free survival was assessed using a Cox proportional hazards regression model. In univariate analysis for disease progression-free survival, increased BM SUV and BLR were associated with poor survival. In multivariate analysis, BLR ( = 0.044; hazard ratio, 1.96), TNM stage ( = 0.014; hazard ratio, 2.87) and maximum FDG uptake of the primary tumor ( = 0.046; hazard ratio, 2.38) were independently associated with disease progression-free survival. For distant failure-free survival, BLR, TNM stage, tumor size, and metabolic parameters of the primary tumor showed prognostic significance in univariate analysis. However, none of the variables showed significance in multivariate analysis. FDG uptake of BM in HNSCC patients might be a significant predictor for disease progression-free survival. Further studies with large patient population are needed to validate the results.
本研究的目的是评估头颈部鳞状细胞癌（HNSCC）患者正电子发射断层扫描/计算机断层扫描（PET/CT）中骨髓（BM）的F-18氟脱氧葡萄糖（FDG）摄取与生存之间的关系。我们回顾性纳入了157例接受分期FDG PET/CT及后续治疗的HNSCC患者。在PET/CT上，测量原发性肿瘤的代谢特征、骨髓的平均FDG摄取（BM SUV）以及骨髓与肝脏摄取比值（BLR）。使用Cox比例风险回归模型评估骨髓FDG摄取对预测无疾病进展生存和无远处转移生存的预后意义。在无疾病进展生存的单因素分析中，BM SUV和BLR升高与生存不良相关。在多因素分析中，BLR（P = 0.044；风险比，1.96）、TNM分期（P = 0.014；风险比，2.87）和原发性肿瘤的最大FDG摄取（P = 0.046；风险比，2.38）与无疾病进展生存独立相关。对于无远处转移生存，在单因素分析中，BLR、TNM分期、肿瘤大小和原发性肿瘤的代谢参数显示出预后意义。然而，在多因素分析中，没有变量显示出显著性。HNSCC患者骨髓的FDG摄取可能是无疾病进展生存的重要预测指标。需要进一步纳入大量患者的研究来验证结果。
