Kaida Hayato, Azuma Koichi, Kawahara Akihiko, Takamori Shinzo, Akiba Jun, Fujimoto Kiminori, Ishii Kazunari, Ishibashi Masatoshi
Department of Radiology, Kindai University Faculty of Medicine, Osakasayama.
Division of Respirology, Neurology, and Rheumatology, and Department of Internal Medicine, Kurume University School of Medicine.
Nucl Med Commun. 2020 Jan;41(1):48-57. doi: 10.1097/MNM.0000000000001118.
To investigate the relationship between the prognosis and glucose transporter-1 (Glut-1) expression or fluorine-18 fluorodeoxyglucose uptake using partial volume correction and dual-point imaging in surgically resected nonsmall cell lung cancer (NSCLC) patients.
Our patient population consisted of 108 NSCLC cases. The early maximum standardized uptake value (ESUVmax), delayed SUVmax (DSUVmax), partial volume correction SUVmax (cSUVmax) and retention index of primary lesions were calculated. Cox proportional hazard model was applied to evaluate the effects of PET parameters and Glut-1 expression. Overall survival (OS) and disease-free survival (DFS) were evaluated by Kaplan-Meier methods, and the difference in survival between subgroups was analyzed by log-rank test.
On the Cox regression analysis, ESUVmax, DSUVmax, cSUVmax and Glut-1 were significantly related to DFS [ESUVmax, hazard ratio = 2.301, 95% confidential interval (CI) = 1.146-4.618, P = 0.019; DSUVmax, hazard ratio = 2.483, 95% CI = 1.257-4.905, P = 0.009; cSUVmax, hazard ratio = 2.205, 95% CI = 1.038-4.686, P = 0.04; Glut-1, hazard ratio = 2.095, 95% CI = 1.086-4.041, P = 0.001] and OS (ESUVmax, hazard ratio = 3.197, 95% CI = 1.339-7.633, P = 0.009; DSUVmax, hazard ratio = 3.599, 95% CI = 1.521-8.516, P = 0.004; cSUVmax, hazard ratio = 8.655, 95% CI = 2.048-36.658, P = 0.003; Glut-1, hazard ratio = 2.427, 95% CI = 5.140, P = 0.021). Retention index had no significant association with DFS or OS. On the Kaplan-Meier survival curves, the patients with high ESUVmax, DSUVmax, cSUVmax and Glut-1 showed significantly worse prognosis than those with low values (ESUVmax: DFS, P = 0.001, OS, P = 0.003; DSUVmax: DFS, P = 0.002, OS, P = 0.004; cSUVmax: DFS, P < 0.001, OS, P = 0.013; Glut-1: DFS, P = 0.012, OS, P = 0.002).
cSUVmax, ESUVmax, DSUVmax and Glut-1 may be more useful biomarkers than retention index for predicting outcomes in NSCLC patients.
采用部分容积校正和双点成像技术，研究手术切除的非小细胞肺癌（NSCLC）患者的预后与葡萄糖转运蛋白1（Glut-1）表达或氟-18氟脱氧葡萄糖摄取之间的关系。
我们的患者群体包括108例NSCLC病例。计算原发灶的早期最大标准化摄取值（ESUVmax）、延迟SUVmax（DSUVmax）、部分容积校正SUVmax（cSUVmax）和滞留指数。应用Cox比例风险模型评估PET参数和Glut-1表达的影响。采用Kaplan-Meier方法评估总生存期（OS）和无病生存期（DFS），并通过对数秩检验分析亚组间生存期的差异。
在Cox回归分析中，ESUVmax、DSUVmax、cSUVmax和Glut-1与DFS显著相关[ESUVmax，风险比=2.301，95%置信区间（CI）=1.146 - 4.618，P = 0.019；DSUVmax，风险比=2.483，95% CI = 1.257 - 4.905，P = 0.009；cSUVmax，风险比=2.205，95% CI = 1.038 - 4.686，P = 0.04；Glut-1，风险比=2.095，95% CI = 1.086 - 4.041，P = 0.001]以及与OS显著相关（ESUVmax，风险比=3.197，95% CI = 1.339 - 7.633，P = 0.009；DSUVmax，风险比=3.599，95% CI = 1.521 - 8.516，P = 0.004；cSUVmax，风险比=8.655，95% CI = 2.048 - 36.658，P = 0.003；Glut-1，风险比=2.427，95% CI = 5.140，P = 0.021）。滞留指数与DFS或OS无显著关联。在Kaplan-Meier生存曲线上，ESUVmax、DSUVmax、cSUVmax和Glut-1高值的患者预后明显比低值患者差（ESUVmax：DFS，P = 0.001，OS，P = 0.003；DSUVmax：DFS，P = 0.002，OS，P = 0.004；cSUVmax：DFS，P < 0.001，OS，P = 0.013；Glut-1：DFS，P = 0.012，OS，P = 0.002）。
对于预测NSCLC患者的预后，cSUVmax、ESUVmax、DSUVmax和Glut-1可能是比滞留指数更有用的生物标志物。
