Chong Gun Oh, Jeong Shin Young, Lee Yoon Hee, Park Shin-Hyung, Lee Hyun Jung, Lee Sang-Woo, Hong Dae Gy, Lee Yoon Soon
Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
Department of Obstetrics and Gynecology, Kyungpook National University Chilgok Hospital, Daegu 41404, Korea.
J Clin Med. 2020 Jun 16;9(6):1878. doi: 10.3390/jcm9061878.
We sought to evaluate whether the F-fluorodeoxyglucose uptake normalization of the primary tumor to both the liver and blood pool and lymph nodes to both the liver and blood pool can enhance the discrimination for prognosis prediction in patients with cervical cancer.
A total of 156 patients with cervical cancer (International Federation of Gynecology and Obstetrics stages IIB-IV) treated with concurrent chemoradiotherapy (CCRT) were enrolled. The maximum standardized uptake value (SUV) of tumor (tSUV) and the lymph node (nSUV) divided by the SUV of the liver (tumor-to-liver ratio (TLR) and node-to-liver (NLR)) and blood pool (tumor-to-blood ratio (TBR) and node-to-blood ratio (NBR)) were investigated. Univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS) were performed using clinical and metabolic parameters. A receiver operating characteristic curve analysis was performed to compare the accuracy of the metabolic parameters.
The multivariate analysis revealed that NLR (hazard ratio ((HR): 3.54; 95% confidence interval (CI): 1.53-8.19; = 0.0032) and NBR (HR: 3.38; 95% CI: 1.02-11.19; = 0.0457)) were independent prognostic factors for DFS, while TLR (HR: 4.16; 95% CI: 1.19-14.50; = 0.0252), TBR (HR: 3.01; 95% CI: 1.04-8.70; = 0.0415), NLR (HR: 4.84; 95% CI: 1.58-14.81; = 0.0057), and NBR (HR: 6.87; 95% CI: 1.55-30.54; = 0.0113) were significant prognostic factors for OS. The normalization of tSUV to the liver or blood pool enhanced the discrimination for prediction of recurrence (tSUV vs. TLR; = 0.0056 and tSUV vs. TBR; = 0.0099) and death (tSUV vs. TLR; < 0.0001 and tSUV vs. TBR; = 0.0001).
The normalization of tSUV was an independent prognostic factor and improved the discrimination for the prediction of tumor recurrence and death in patients with locally advanced cervical cancer treated with CCRT.
我们试图评估原发性肿瘤对肝脏和血池的F-氟脱氧葡萄糖摄取标准化以及淋巴结对肝脏和血池的摄取标准化是否能增强对宫颈癌患者预后预测的判别能力。
共纳入156例接受同步放化疗（CCRT）的宫颈癌患者（国际妇产科联盟分期IIB-IV期）。研究了肿瘤的最大标准化摄取值（SUV）（tSUV）和淋巴结的最大标准化摄取值（nSUV）除以肝脏的SUV（肿瘤与肝脏比值（TLR）和淋巴结与肝脏比值（NLR））以及血池的SUV（肿瘤与血池比值（TBR）和淋巴结与血池比值（NBR））。使用临床和代谢参数对无病生存期（DFS）和总生存期（OS）进行单因素和多因素分析。进行了受试者工作特征曲线分析以比较代谢参数的准确性。
多因素分析显示，NLR（风险比（HR）：3.54；95%置信区间（CI）：1.53-8.19；P = 0.0032）和NBR（HR：3.38；95%CI：1.02-11.19；P = 0.0457）是DFS的独立预后因素，而TLR（HR：4.16；95%CI：1.19-14.50；P = 0.0252）、TBR（HR：3.01；95%CI：1.04-8.70；P = 0.0415）、NLR（HR：4.84；95%CI：1.58-14.81；P = 0.0057）和NBR（HR：6.87；95%CI：1.55-30.54；P = 0.0113）是OS的显著预后因素。tSUV对肝脏或血池的标准化增强了对复发预测（tSUV与TLR比较；P = 0.0056以及tSUV与TBR比较；P = 0.0099）和死亡预测（tSUV与TLR比较；P < 0.0001以及tSUV与TBR比较；P = 0.0001）的判别能力。
tSUV的标准化是一个独立的预后因素，提高了对接受CCRT治疗的局部晚期宫颈癌患者肿瘤复发和死亡预测的判别能力。
