Filippi Luca, Di Costanzo Giovan Giuseppe, Tortora Raffaella, Pelle Giuseppe, Saltarelli Adelchi, Marino Marsilia Giuseppina, Cianni Roberto, Schillaci Orazio, Bagni Oreste
Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina.
Department of Transplantation - Liver Unit, Cardarelli Hospital, Naples.
Nucl Med Commun. 2020 Jan;41(1):78-86. doi: 10.1097/MNM.0000000000001123.
The aim of this study was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and its relationship with several metabolic parameters obtained through PET in intrahepatic cholangiocarcinoma (ICC) submitted to radioembolization with Y-microspheres (Y-radioembolization).
Records of 20 subjects affected by ICC and submitted to Y-radioembolization were retrospectively evaluated. In all cases, pretreatment NLR was carried out and fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT was acquired with the calculation of the following metabolic parameters: maximum and mean standardized uptake value (SUVmax and SUVmean), metabolic total volume and total lesion glycolysis. After Y-radioembolization, all patients underwent regular imaging and laboratory follow-up.
All patients presented F-FDG-avid hepatic tumors at pretreatment PET/CT examination. NLR significantly correlated with SUVmax (r = 0.64; P = 0.002) and SUVmean (r = 0.67; P = 0.001). After treatment with Y-microspheres, the mean OS resulted 12.5 ± 1.5 months. When the average pretreatment NLR value (i.e. 2.7) was used as a cutoff for patients' stratification, subjects with low NLR (<2.7) had a significantly longer OS than those with high NLR (>2.7). At Cox regression analysis including bilirubin, age, the presence of extrahepatic disease, hepatitis C virus/hepatitis B virus status and PET-derived parameters, only NLR resulted to be a significant predictor of OS (P = 0.01; hazard ratio = 13.1, 95% confidence interval = 1.6-102.7).
NLR is correlated with SUVmax-mean values in ICC and resulted to be an easy available predictor of survival in patients submitted to treatment with Y-microspheres.
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）在接受钇微球放射性栓塞治疗（Y-放射性栓塞）的肝内胆管癌（ICC）中的预后价值及其与通过PET获得的几个代谢参数的关系。
回顾性评估20例受ICC影响并接受Y-放射性栓塞治疗的患者记录。所有病例均进行了治疗前NLR检测，并进行了氟-18-氟脱氧葡萄糖（F-FDG）PET/CT检查，计算以下代谢参数：最大和平均标准化摄取值（SUVmax和SUVmean）、代谢总体积和总病灶糖酵解。Y-放射性栓塞治疗后，所有患者均接受定期影像学和实验室随访。
所有患者在治疗前PET/CT检查时均表现为F-FDG摄取阳性的肝肿瘤。NLR与SUVmax（r = 0.64；P = 0.002）和SUVmean（r = 0.67；P = 0.001）显著相关。用钇微球治疗后，平均总生存期为12.5±1.5个月。当将治疗前NLR平均值（即2.7）用作患者分层的临界值时，NLR低（<2.7）的患者总生存期明显长于NLR高（>2.7）的患者。在包括胆红素、年龄、肝外疾病的存在、丙型肝炎病毒/乙型肝炎病毒状态和PET衍生参数的Cox回归分析中，只有NLR是总生存期的显著预测因子（P = 0.01；风险比 = 13.1，95%置信区间 = 1.6 - 102.7）。
NLR与ICC中的SUVmax-mean值相关，并且是接受钇微球治疗患者生存的一个易于获得的预测因子。
