Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2019 Aug 21;9(1):12215. doi: 10.1038/s41598-019-48674-4.
We investigated the relationship between tumor F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) scans and thymidylate synthase (TS) expression. In addition, we evaluated the value of FDG uptake in predicting treatment response and prognosis when combined with TS expression in patients with advanced non-small cell lung cancer (NSCLC). We measured the maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of tumor lesions on pretreatment scan in 234 patients (age: 60.1 ± 9.4 years; males: 56.4%) with stage IV non-squamous NSCLC who were enrolled in the prospective phase II clinical trial. We investigated the correlation of the parameters with TS expression and the predictive values of the parameters compared with other clinical factors. Among these parameters, TLG was the most relevant parameter that had a significant correlation with TS expression (ρ = 0.192, P = 0.008). A multivariable Cox proportional-hazards model revealed that high TLG was a significant independent predictor for treatment response (hazard ratio [HR]: 2.05; P = 0.027), progression-free survival (HR: 1.39; P = 0.043), and overall survival (HR: 1.65; P = 0.035) with other factors. In patients with advanced non-squamous NSCLC, tumor TLG on pretreatment PET/CT scan has predictive and prognostic value.
我们研究了正电子发射断层扫描/计算机断层扫描（PET/CT）扫描中肿瘤 F-氟代脱氧葡萄糖（FDG）摄取与胸苷酸合成酶（TS）表达之间的关系。此外，我们评估了在晚期非小细胞肺癌（NSCLC）患者中，将 FDG 摄取与 TS 表达相结合，对治疗反应和预后的预测价值。我们在 234 名接受 IV 期非鳞状 NSCLC 前瞻性 II 期临床试验的患者的预处理扫描中测量了肿瘤病变的最大标准摄取值、代谢肿瘤体积和总肿瘤糖酵解（TLG）。我们研究了这些参数与 TS 表达的相关性，并与其他临床因素相比，对这些参数的预测价值进行了研究。在这些参数中，TLG 是与 TS 表达相关性最强的参数（ρ=0.192，P=0.008）。多变量 Cox 比例风险模型显示，高 TLG 是治疗反应（风险比[HR]：2.05；P=0.027）、无进展生存期（HR：1.39；P=0.043）和总生存期（HR：1.65；P=0.035）的独立显著预测因素，而其他因素则无预测价值。在晚期非鳞状 NSCLC 患者中，预处理 PET/CT 扫描中的肿瘤 TLG 具有预测和预后价值。
