Sperti Cosimo, Friziero Alberto, Serafini Simone, Bissoli Sergio, Ponzoni Alberto, Grego Andrea, Grego Emanuele, Moletta Lucia
Department of Surgery, Oncology and Gastroenterology, 3rd Surgical Clinic, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
Nuclear Medicine, Belluno General Hospital, Viale Europa 22, 32100 Belluno, Italy.
J Clin Med. 2020 Jul 9;9(7):2169. doi: 10.3390/jcm9072169.
There are currently no known preoperative factors for determining the prognosis in pancreatic cancer. The aim of this study was to examine the role of 18-fluorodeoxyglucose (18-FDG) positron emission tomography/computed tomography (18-FDG-PET/CT) as a prognostic factor for patients with resectable pancreatic cancer. Data were obtained from a retrospective analysis of patients who had a preoperative PET scan and then underwent pancreatic resection from January 2007 to December 2015. The maximum standardized uptake value (SUVmax) of 18-FDG-PET/CT was calculated. Patients were divided into high (>3.65) and low (≤3.65) SUVmax groups, and compared in terms of their TNM classification (Union for International Cancer Contro classification), pathological grade, surgical treatment, state of resection margins, lymph node involvement, age, sex, diabetes and serum Carbohydrate Antigen 19-9 (CA 19-9) levels. The study involved 144 patients, 82 with high SUVmax pancreatic cancer and 62 with low SUVmax disease. The two groups' disease-free and overall survival rates were significantly influenced by tumor stage, lymph node involvement, pathological grade, resection margins and SUVmax. Patients with an SUVmax ≤ 3.65 had a significantly better survival than those with SUVmax > 3.65 ( < 0.001). The same variables were independent predictors of survival on multivariate analysis. The SUVmax calculated with 18-FDG-PET/CT is an important prognostic factor for patients with pancreatic cancer, and may be useful in decisions concerning patients' therapeutic management.
目前尚无已知的术前因素可用于确定胰腺癌的预后。本研究的目的是探讨18-氟脱氧葡萄糖（18-FDG）正电子发射断层扫描/计算机断层扫描（18-FDG-PET/CT）作为可切除胰腺癌患者预后因素的作用。数据来自对2007年1月至2015年12月期间术前行PET扫描并随后接受胰腺切除术的患者的回顾性分析。计算18-FDG-PET/CT的最大标准化摄取值（SUVmax）。患者分为SUVmax高（>3.65）和低（≤3.65）两组，并在TNM分类（国际癌症控制联盟分类）、病理分级、手术治疗、切缘状态、淋巴结受累情况、年龄、性别、糖尿病和血清糖类抗原19-9（CA 19-9）水平方面进行比较。该研究纳入了144例患者，其中82例为SUVmax高的胰腺癌患者，62例为SUVmax低的患者。两组的无病生存率和总生存率受肿瘤分期、淋巴结受累情况、病理分级、切缘和SUVmax的显著影响。SUVmax≤3.65的患者生存率明显优于SUVmax>3.65的患者（<0.001）。在多变量分析中，相同的变量是生存的独立预测因素。用18-FDG-PET/CT计算的SUVmax是胰腺癌患者的一个重要预后因素，可能有助于做出有关患者治疗管理的决策。
