F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描联合血小板-淋巴细胞比值预测鼻咽癌预后的价值。

Usefulness of F-fluorodeoxyglucose positron-emission tomography/computed tomography combined with the platelet-lymphocyte ratio in predicting the prognosis of nasopharyngeal carcinoma.

机构信息

Department of Nuclear Medicine, The First People's Hospital of Foshan, Foshan, China.

出版信息

Br J Radiol. 2022 Jan 1;95(1129):20210279. doi: 10.1259/bjr.20210279. Epub 2021 Nov 23.

DOI:10.1259/bjr.20210279

PMID:34813375

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8722261/

Abstract

OBJECTIVES

To investigate the value of F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) combined with the platelet-lymphocyte ratio (PLR) in predicting the prognosis of nasopharyngeal carcinoma (NPC).

METHODS

This was a retrospective analysis of the data of 73 patients with NPC who underwent F-FDG PET/CT before treatment from January 2010 to December 2014. The maximum standard uptake value (SUVmax) of NPC and the PLR within 1 week before treatment were both measured. The Mann-Whitney U-test was used to compare the differences between the SUVmax and PLR among the different clinical characteristics of patients with NPC and the 5-year progression-free survival (PFS) rate; according to the receiver operating characteristic (ROC) curve, the best cutoff values of the SUVmax and PLR were obtained and used to group patients. The Kaplan-Meier method and Log-rank test were used to conduct univariate analysis of 5-year PFS in patients with NPC, and Cox regression was used to conduct multivariate analysis; differences in the 5-year PFS of patients with different SUVmax values combined with the PLR were compared.

RESULTS

The SUVmax and PLR of patients with disease progression within 5 years were higher than those of patients without disease progression ( = 0.006 and = 0.026). SUVmax = 9.7 and PLR = 132.98 had the best prognostic diagnostic efficiency for patients. Cox multivariate analysis showed that the SUVmax and PLR are independent factors affecting the prognosis of NPC. The 5-year PFS of patients with SUVmax <9.7 was significantly higher than that of patients with SUVmax ≥9.7 in the high PLR group (PLR ≥132.98) and in the low PLR group (PLR <132.98) (59.3% 29.4%, = 0.033 and 90.9% v 42.9%, = 0.006, respectively). For patients with SUVmax <9.7, the 5-year PFS of the high PLR group was significantly lower than the low PLR group (59.3% 90.9%, ); for patients with SUVmax ≥9.7, there was no significant difference in 5-year PFS between the high PLR group and the low PLR group (29.4% 42.9%, = 0.406).

CONCLUSIONS

Both the SUVmax of the primary tumor and the PLR before treatment have an important influence on the prognosis of NPC. Combining the SUVmax and the PLR can more accurately predict the prognosis of patients with NPC.

ADVANCES IN KNOWLEDGE

In this study, we evaluated the prognostic value of combining pretreatment tumor F-FDG uptake on PET/CT imaging and PLR in NPC patients. We found that both SUVmax and PLR are independent factors for the PFS of NPC patients, and a low SUVmax (SUVmax <9.7) combined with a low PLR (PLR <132.98) revealed significant PFS benefit.

摘要

目的

探讨氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）联合血小板-淋巴细胞比值（PLR）预测鼻咽癌（NPC）预后的价值。

方法

回顾性分析 2010 年 1 月至 2014 年 12 月 73 例 NPC 患者治疗前 F-FDG PET/CT 资料，测量 NPC 最大标准摄取值（SUVmax）和治疗前 1 周内的 PLR。采用 Mann-Whitney U 检验比较不同 NPC 临床特征患者 SUVmax 和 PLR 的差异及 5 年无进展生存率（PFS）率；根据受试者工作特征（ROC）曲线，获取 SUVmax 和 PLR 的最佳截断值，分组患者。采用 Kaplan-Meier 法和 Log-rank 检验对 NPC 患者 5 年 PFS 进行单因素分析，采用 Cox 回归进行多因素分析；比较不同 SUVmax 值结合 PLR 的患者 5 年 PFS 的差异。

结果

5 年内疾病进展患者的 SUVmax 和 PLR 高于无疾病进展患者（ = 0.006 和 = 0.026）。SUVmax = 9.7 和 PLR = 132.98 对患者的预后诊断效率最佳。Cox 多因素分析显示，SUVmax 和 PLR 是影响 NPC 预后的独立因素。SUVmax＜9.7 的患者在高 PLR 组（PLR≥132.98）和低 PLR 组（PLR＜132.98）的 5 年 PFS 明显高于 SUVmax≥9.7 的患者（59.3% 比 29.4%， = 0.033 和 90.9% 比 42.9%， = 0.006）。对于 SUVmax＜9.7 的患者，高 PLR 组的 5 年 PFS 明显低于低 PLR 组（59.3% 比 90.9%）；对于 SUVmax≥9.7 的患者，高 PLR 组和低 PLR 组 5 年 PFS 无显著差异（29.4% 比 42.9%， = 0.406）。