Zhao C Y, Deng X Y, Wang H S, Cao G P, Ding J N, Ding C Y
Department of Radiology, Jiangsu University Affiliated Aoyang Hospital, Suzhou 215600, China.
Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Zhong Liu Za Zhi. 2021 Jul 23;43(7):795-800. doi: 10.3760/cma.j.cn112152-20190111-00006.
To investigate the value of (18)F-fluorodeoxy glucose ((18)F-FDG) positron emission tomography/computed tomography (PET-CT) in predicting the epidermal growth factor receptor (EGFR) mutations in patients with lung squamous cell carcinoma. We retrospectively analyzed the clinical data and (18)F-FDG PET-CT imaging data of 206 patients with lung squamous cell carcinoma confirmed by pathology and underwent EGFR mutation test in the First Affiliated Hospital of Nanjing Medical University from June 2013 to October 2018. Receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of maximum standard uptake value (SUV(max)), metabolic tumor volume (MTV), total lesion glycolysis (TLG). The - test was used to assess the difference in PET parameters. A multivariate Logistic regression analysis was performed to yield the parameters with statistic difference. All of 206 patients with lung squamous cell carcinoma showed a high (18)F-FDG uptake. The median of SUV(max), MTV and TLG were 19.14, 37.69 cm(3) and 291.73, respectively. Among the 206 patients, EGFR mutations were identified in 14 cases, including 7 with exon 21 (L858R) mutation, 6 with exon 19 mutation and 1 with exon 20 mutation. ROC curve showed that the AUC of SUV(max), MTV and TLG were 0.624 (95% =0.454-0.794, =0.122), 0.892 (95% =0.811-0.973, <0.001) and 0.860 (95% =0.768-0.952, <0.001), respectively. The median SUV(max) (19.14) was used as the cutoff points due to the small value of AUC. The cutoff point of MTV was 20.09 cm(3), the cutoff point of TLG was 211.07. Univariate analysis showed that the sex, smoking history, M stage, MTV and TLG were associated with EGFR mutations (all <0.05). Logistic multivariate analysis showed that the sex, smoking history and TLG were the independent predictors of EGFR mutation (all <0.05). TLG detected by (18)F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with lung squamous cell carcinoma, and has certain reference value for predicting EGFR mutation.
探讨¹⁸F-氟脱氧葡萄糖(¹⁸F-FDG)正电子发射断层扫描/计算机断层扫描(PET-CT)在预测肺鳞状细胞癌患者表皮生长因子受体(EGFR)突变中的价值。我们回顾性分析了2013年6月至2018年10月在南京医科大学第一附属医院经病理确诊并接受EGFR突变检测的206例肺鳞状细胞癌患者的临床资料和¹⁸F-FDG PET-CT影像资料。采用受试者操作特征(ROC)曲线分析来量化最大标准摄取值(SUV(max))、代谢肿瘤体积(MTV)、总病灶糖酵解(TLG)的预测价值。采用t检验评估PET参数的差异。进行多因素Logistic回归分析以得出具有统计学差异的参数。206例肺鳞状细胞癌患者¹⁸F-FDG摄取均较高。SUV(max)、MTV和TLG的中位数分别为19.14、37.69 cm³和291.73。206例患者中,14例检测到EGFR突变,其中7例为21外显子(L858R)突变,6例为19外显子突变,1例为20外显子突变。ROC曲线显示,SUV(max)、MTV和TLG的AUC分别为0.624(95%CI =0.454-0.794,P =0.122)、0.892(95%CI =0.811-0.973,P<0.001)和0.860(95%CI =0.768-0.952,P<0.001)。由于AUC值较小,将SUV(max)中位数(19.14)作为截断点。MTV的截断点为20.09 cm³,TLG的截断点为211.07。单因素分析显示,性别、吸烟史、M分期、MTV和TLG与EGFR突变相关(均P<0.05)。多因素Logistic分析显示,性别、吸烟史和TLG是EGFR突变的独立预测因素(均P<0.05)。¹⁸F-FDG PET/CT检测的TLG是预测肺鳞状细胞癌患者EGFR突变的独立因素,对预测EGFR突变有一定参考价值。