PET/CT 中脂肪组织分布和代谢活性对转移性结直肠癌患者预后的意义。
Prognostic Significance of Adipose Tissue Distribution and Metabolic Activity in PET/CT in Patients with Metastatic Colorectal Cancer.
机构信息
Department of Internal Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
Department of Nuclear Medicine, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
出版信息
J Gastrointest Cancer. 2023 Jun;54(2):456-466. doi: 10.1007/s12029-022-00819-x. Epub 2022 Apr 11.
PURPOSE
In this study, we aimed to evaluate the prognostic significance of adipose tissue distribution and metabolic activity in PET/CT to predict survival in patients with metastatic colorectal cancer (mCRC).
METHODS
The volume, density (HU), and FDG uptake (standardized uptake value (SUV)) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) and maximum FDG uptake of the tumor tissue were measured. Subcutaneous adipose tissue of volume-to-density ratio (SAT ratio) was calculated.
RESULTS
The median OS for the patients with SAT ratio value < -1.1 and ≥ -1.1 were 38.5 (95% CI 31.54-45.58) and 24.5 (95% CI 14.13-34.93) months, respectively (p = 0.05). During follow-up, 69 patients experienced disease progression. The median progression-free survival (PFS) was 11.03 months (95% CI: 9.11-12.95). Median PFS for patients with tumor SUV max value < 11.5 and ≥ 11.5 were 9.2 (95% CI 7.25-11.27) and 12.6 (95% CI 10.02-15.27) months, respectively (p = 0.14). Forty-eight patients received bevacizumab therapy. VAT SUV mean (HR: 0.09; 95% CI 0.01-0.52, p = 0.008) was significantly associated with PFS in patients receiving bevacizumab. SAT ratio was the significant parameter for the OS (HR: 0.58; 95% CI 0.33-1.01, p = 0.05) and PFS (HR: 1.99; 95% CI 1.02-3.91, p = 0.043).
CONCLUSIONS
SAT ratio was an independent prognostic factor for survival in patients with mCRC. Higher SAT volume is correlated with longer survival in mCRC patients.
目的
本研究旨在评估 PET/CT 中脂肪组织分布和代谢活性对预测转移性结直肠癌（mCRC）患者生存的预后意义。
方法
测量内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的体积、密度（HU）和 FDG 摄取（标准化摄取值（SUV））以及肿瘤组织的最大 FDG 摄取量。计算 SAT 体积密度比（SAT 比）。
结果
SAT 比值值＜-1.1 和≥-1.1 的患者中位 OS 分别为 38.5（95%CI 31.54-45.58）和 24.5（95%CI 14.13-34.93）个月（p=0.05）。在随访期间，69 名患者出现疾病进展。中位无进展生存期（PFS）为 11.03 个月（95%CI：9.11-12.95）。肿瘤 SUV max 值＜11.5 和≥11.5 的患者中位 PFS 分别为 9.2（95%CI 7.25-11.27）和 12.6（95%CI 10.02-15.27）个月，差异无统计学意义（p=0.14）。48 名患者接受贝伐单抗治疗。接受贝伐单抗治疗的患者中，VAT SUV 均值（HR：0.09；95%CI 0.01-0.52，p=0.008）与 PFS 显著相关。SAT 比值是 OS（HR：0.58；95%CI 0.33-1.01，p=0.05）和 PFS（HR：1.99；95%CI 1.02-3.91，p=0.043）的独立预后因素。
结论
SAT 比值是 mCRC 患者生存的独立预后因素。较高的 SAT 体积与 mCRC 患者的生存时间延长相关。
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