Tustumi Francisco, Albenda David Gutiérrez, Perrotta Fernando Simionato, Sallum Rubens Antonio Aissar, Ribeiro Junior Ulysses, Buchpiguel Carlos Alberto, Duarte Paulo Schiavom
Department of Gastroenterology, Digestive Surgery Division, Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo 05403-000, SP, Brazil.
Department of Radiology and Oncology, Nuclear Medicine Division, Universidade de São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo 05403-000, SP, Brazil.
J Imaging. 2022 Oct 31;8(11):297. doi: 10.3390/jimaging8110297.
Fluorine-18-fluorodeoxyglucose positron emission tomography/computerized tomography (18F-FDG PET/CT) uptake is known to increase in infective and inflammatory conditions. Systemic inflammation plays a role in oncologic prognosis. Consequently, bone marrow increased uptake in oncology patients could potentially depict the systemic cancer burden.
A single institute cohort analysis and a systematic review were performed, evaluating the prognostic role of 18F-FDG uptake in the bone marrow in solid neoplasms before treatment. The cohort included 113 esophageal cancer patients (adenocarcinoma or squamous cell carcinoma). The systematic review was based on 18 studies evaluating solid neoplasms, including gynecological, lung, pleura, breast, pancreas, head and neck, esophagus, stomach, colorectal, and anus.
Bone marrow 18F-FDG uptake in esophageal cancer was not correlated with staging, pathological response, and survival. High bone marrow uptake was related to advanced staging in colorectal, head and neck, and breast cancer, but not in lung cancer. Bone marrow 18F-FDG uptake was significantly associated with survival rates for lung, head and neck, breast, gastric, colorectal, pancreatic, and gynecological neoplasms but was not significantly associated with survival in pediatric neuroblastoma and esophageal cancer.
18F-FDG bone marrow uptake in PET/CT has prognostic value in several solid neoplasms, including lung, gastric, colorectal, head and neck, breast, pancreas, and gynecological cancers. However, future studies are still needed to define the role of bone marrow role in cancer prognostication.
已知在感染性和炎症性疾病中，氟-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）摄取会增加。全身炎症在肿瘤预后中起作用。因此，肿瘤患者骨髓摄取增加可能反映全身癌症负担。
进行了一项单机构队列分析和系统评价，评估治疗前18F-FDG在实体瘤骨髓中的摄取对预后的作用。该队列包括113例食管癌患者（腺癌或鳞状细胞癌）。系统评价基于18项评估实体瘤的研究，包括妇科、肺癌、胸膜、乳腺癌、胰腺癌、头颈部、食管、胃、结直肠和肛门癌。
食管癌患者骨髓18F-FDG摄取与分期、病理反应和生存率无关。高骨髓摄取与结直肠癌、头颈部癌和乳腺癌的晚期分期相关，但与肺癌无关。骨髓18F-FDG摄取与肺癌、头颈部癌、乳腺癌、胃癌、结直肠癌、胰腺癌和妇科肿瘤的生存率显著相关，但与小儿神经母细胞瘤和食管癌的生存率无显著相关性。
PET/CT中18F-FDG骨髓摄取在几种实体瘤中具有预后价值，包括肺癌、胃癌、结直肠癌、头颈部癌、乳腺癌、胰腺癌和妇科癌。然而，仍需要进一步研究来确定骨髓在癌症预后中的作用。
