Wang Yubo, Han Rui, Wang Qiushi, Zheng Jie, Lin Caiyu, Lu Conghua, Li Li, Chen Hengyi, Jin Rongbing, He Yong
Department of Respiratory Medicine, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.
Department of Pathology, Daping Hospital, Army Medical University, Chongqing, People's Republic of China.
Int J Gen Med. 2021 Feb 3;14:347-356. doi: 10.2147/IJGM.S287506. eCollection 2021.
To investigate the potential of maximum standardized uptake value (SUVmax) in predicting epidermal growth factor receptor () mutation status in non-small cell lung cancer (NSCLC) patients.
Clinical data of 311 NSCLC patients who had undergone both mutation test and F-FDG PET/CT scans between January 2013 and December 2017 at our hospital were retrospectively analyzed. Patients were sub-grouped by their origin of SUVmax. Univariate and multivariate analyses were performed to investigate the association between clinical factors and mutations. Receiver operating characteristic curve (ROC) analysis was performed to confirm the predictive value of clinical factors. In vitro experiments were performed to confirm the correlation between mutations and glycolysis.
-mutant patients had higher SUVmax than the wild-type patients in both primary tumors and metastases. In the multivariate analysis, SUVmax, gender and histopathologic type were determined as independent predictors of mutation status for patients whose SUVmax were obtained from the primary tumors; while for patients whose SUVmax were obtained from the metastases, SUVmax, smoking status and histopathologic type were regarded as independent predictors. ROC analysis showed that SUVmax of the primary tumors (cut off >10.92), not of the metastases, has better predictive value than other clinical factors in predicting mutation status. The predict performance was improved after combined SUVmax with other independent predictors. In addition, our in vitro experiments demonstrated that lung cancer cells with mutations have higher aerobic glycolysis level than wild-type cells.
SUVmax of the primary tumors has the potential to serve as a biomarker to predict mutation status in NSCLC patients.
探讨最大标准化摄取值（SUVmax）预测非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）突变状态的潜力。
回顾性分析2013年1月至2017年12月在我院接受EGFR突变检测和F-FDG PET/CT扫描的311例NSCLC患者的临床资料。根据SUVmax来源对患者进行亚组分析。进行单因素和多因素分析以研究临床因素与EGFR突变之间的关联。绘制受试者工作特征曲线（ROC）以确定临床因素的预测价值。进行体外实验以证实EGFR突变与糖酵解之间的相关性。
EGFR突变患者的原发肿瘤和转移灶的SUVmax均高于野生型患者。多因素分析中，对于SUVmax来自原发肿瘤的患者，SUVmax、性别和组织病理学类型被确定为EGFR突变状态的独立预测因素；而对于SUVmax来自转移灶的患者，SUVmax、吸烟状态和组织病理学类型被视为独立预测因素。ROC分析表明，原发肿瘤的SUVmax（截断值>10.92）而非转移灶的SUVmax在预测EGFR突变状态方面比其他临床因素具有更好的预测价值。将SUVmax与其他独立预测因素联合后预测性能得到改善。此外，我们的体外实验表明，具有EGFR突变的肺癌细胞比野生型细胞具有更高的有氧糖酵解水平。
原发肿瘤的SUVmax有潜力作为预测NSCLC患者EGFR突变状态的生物标志物。
