结直肠癌患者 FDG PET/CT 中肿瘤周围脂肪组织影像学特征的预后意义。

Prognostic significance of imaging features of peritumoral adipose tissue in FDG PET/CT of patients with colorectal cancer.

机构信息

Department of Pathology, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan, Chungcheongnam-do 31151, Republic of Korea.

Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, 25 Simgok-ro 100-gil, Seo-gu, Incheon 22711, Republic of Korea.

出版信息

Eur J Radiol. 2021 Dec;145:110047. doi: 10.1016/j.ejrad.2021.110047. Epub 2021 Nov 17.

DOI:10.1016/j.ejrad.2021.110047

PMID:34801879

Abstract

PURPOSE

This study investigated the relationship of imaging features of primary tumor and peritumoral VAT on PET/CT with histopathological findings of peritumoral VAT and recurrence-free survival (RFS) in patients with colorectal cancer.

METHODS

We retrospectively reviewed 133 patients diagnosed with colorectal cancer who underwent staging FDG PET/CT and received curative surgery. Histogram-based imaging features of primary tumor and peritumoral VAT were extracted from PET/CT images. Based on histopathological analysis of peritumoral VAT, the degree of CD4, CD8, and CD163 cell infiltration and the expression of matrix metalloproteinase-11 and interleukin 6 (IL-6) were graded. Differences in imaging parameters based on the histopathological results and the relationships between imaging features and RFS were assessed.

RESULTS

Mean CT-attenuation and SUV of peritumoral VAT showed significant positive correlation with CD163 cell infiltration and IL-6 expression of peritumoral VAT. Univariable survival analysis revealed significant correlation between RFS and the mean CT-attenuation, mean SUV, and first-order SUV entropy of peritumoral VAT (p < 0.05). Multivariable analysis indicated that mean SUV and SUV entropy of peritumoral VAT remained significant predictors of RFS after adjustment for age, sex, and T stage (p < 0.05).

CONCLUSION

FDG uptake of peritumoral VAT was significantly associated with inflammatory response in peritumoral VAT and was an independent predictor of RFS in colorectal cancer patients.

摘要

目的

本研究旨在探讨原发性肿瘤和肿瘤周围 VAT 的 PET/CT 影像学特征与肿瘤周围 VAT 的组织病理学发现及结直肠癌患者无复发生存率（RFS）之间的关系。

方法

我们回顾性分析了 133 例经 FDG PET/CT 分期检查并接受根治性手术的结直肠癌患者。从 PET/CT 图像中提取原发性肿瘤和肿瘤周围 VAT 的基于直方图的影像学特征。根据肿瘤周围 VAT 的组织病理学分析，对 CD4、CD8 和 CD163 细胞浸润程度以及基质金属蛋白酶-11 和白细胞介素 6（IL-6）的表达进行分级。评估基于组织病理学结果的影像学参数差异以及影像学特征与 RFS 之间的关系。

结果

肿瘤周围 VAT 的 CT 衰减平均值和 SUV 与肿瘤周围 VAT 中的 CD163 细胞浸润和 IL-6 表达呈显著正相关。单变量生存分析显示，RFS 与肿瘤周围 VAT 的 CT 衰减平均值、SUV 平均值和 SUV 一阶熵之间存在显著相关性（p<0.05）。多变量分析表明，在调整年龄、性别和 T 分期后，肿瘤周围 VAT 的 SUV 平均值和 SUV 熵仍然是 RFS 的独立预测因子（p<0.05）。