Ruan Maomei, Liu Liu, Wang Lihua, Lei Bei, Sun Xiaoyan, Chang Cheng, Shen Yan, Xie Wenhui
Department of Nuclear Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.
Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.
Eur J Nucl Med Mol Imaging. 2020 May;47(5):1183-1197. doi: 10.1007/s00259-019-04652-6. Epub 2020 Jan 3.
Our study intended to explore the association between combining F-FDG PET/CT metabolic parameters and other clinical features and anaplastic lymphoma kinase (ALK) or c-ros oncogene 1 (ROS1) fusion in non-small-cell lung cancer (NSCLC).
Eight hundred and six patients with wild-type epidermal growth factor receptor (EGFR) mutation were screened for ALK or ROS1 fusion and subjected to F-FDG PET/CT prior to treatment at our hospital. The associations between ALK or ROS1 fusion and clinical characteristics and the PET/CT parameters were analyzed. Multivariate logistic regression analysis was performed to explore independent deterministic factors associated with ALK and ROS1 fusion.
Eighty-two patients (11.7%) with ALK fusion were found. Multivariate analysis demonstrated that high pSUVmax ≥ 10.6, low primary tumor lesion glycolysis (pTLG) < 101.8, young age, nonsmoker status, and high carcinoembryonic antigen (CEA) level correlated with ALK fusion in NSCLC. The receiver operating characteristic (ROC) curve yielded the area under curve (AUC) values of 0.603 and 0.873 for high pSUVmax alone and the combination of the five factors, respectively. Twenty-six patients (5.6%) with ROS1 fusion were found. Multivariate analysis revealed that high pSUVmax ≥ 8.8, young age, and nonsmoker status correlated with ROS1 fusion in NSCLC. The ROC curve yielded AUC values of 0.662 and 0.813 for high pSUVmax alone and the combination of the three factors, respectively.
The study indicated that combining F-FDG PET/CT metabolic parameters and other clinical parameters were correlated with ALK and ROS1 mutation in NSCLC patients and may help to refine the process of optimal patient selection to gene test for targeted therapy.
我们的研究旨在探讨非小细胞肺癌（NSCLC）中¹⁸F-FDG PET/CT代谢参数与其他临床特征及间变性淋巴瘤激酶（ALK）或c-ros原癌基因1（ROS1）融合之间的关联。
对806例野生型表皮生长因子受体（EGFR）突变患者进行ALK或ROS1融合检测，并在我院治疗前接受¹⁸F-FDG PET/CT检查。分析ALK或ROS1融合与临床特征及PET/CT参数之间的关联。进行多因素逻辑回归分析，以探索与ALK和ROS1融合相关的独立决定因素。
发现82例（11.7%）患者存在ALK融合。多因素分析表明，高标准化摄取值最大值（pSUVmax）≥10.6、低原发肿瘤病变糖酵解（pTLG）<101.8、年轻、不吸烟状态以及高癌胚抗原（CEA）水平与NSCLC中的ALK融合相关。单独高pSUVmax和五个因素组合的受试者工作特征（ROC）曲线下面积（AUC）值分别为0.603和0.873。发现26例（5.6%）患者存在ROS1融合。多因素分析显示，高pSUVmax≥8.8、年轻和不吸烟状态与NSCLC中的ROS1融合相关。单独高pSUVmax和三个因素组合的ROC曲线AUC值分别为0.662和0.813。
该研究表明，¹⁸F-FDG PET/CT代谢参数与其他临床参数相结合与NSCLC患者的ALK和ROS1突变相关，可能有助于优化患者选择以进行靶向治疗的基因检测过程。
