Sawaragi Kazuhito, Okada Yukinori, Aono Yuuki, Yasuoka Ryo, Takayama Shoji, Yao Ryuuji, Mitsuyama Toshiyuki, Saigusa Susumu, Fujikawa Hiroyuki, Mori Tomomi, Hashimoto Manabu, Higashi Koki, Sakurai Hiroyuki, Tanaka Koji, Okugawa Yoshinaga, Tanaka Naoshi, Toiyama Yuji, Okazaki Kazuichi, Naganuma Makoto
Department of Gastroenterology and Hepatology, Iga City General Hospital, Iga, Mie 518-0823, Japan.
Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Osaka 573-1191, Japan.
Oncol Lett. 2023 Apr 3;25(5):197. doi: 10.3892/ol.2023.13783. eCollection 2023 May.
The present study aimed to investigate the factors affecting the cardiac uptake of 18F-fluorodeoxyglucose (18F-FDG) during 18F-FDG positron emission tomography (PET) for new-onset rectal cancer and new-onset colon cancer (ascending, transverse, descending, sigmoid colon cancer) and to examine the association between the cardiac uptake of 18F-FDG and prognosis. The participants were diagnosed with new-onset rectal cancer and new-onset colon cancer (ascending, transverse, descending, sigmoid cancer) at the Iga City General Hospital (Iga, Japan) between January 1, 2013, and March 31, 2018, and underwent an 18F-FDG PET scan for pretreatment staging. The relationship between cardiac maximum standard uptake value (SUVmax), the presence/absence of distant metastasis and prognosis was examined. A total of 26 patients (14 men and 12 women) aged 72.0±10 years with new-onset rectal cancer were selected for the study. No patients had multiple simultaneous cancers. The median cardiac SUVmax was 3.8 and 2.5 in patients with no distant metastasis and distant metastasis, respectively, revealing a statistically significant difference (P<0.01). The median tumor volume on PET-computed tomography (CT) images was 7,815 cm and was 66,248 cm in patients with no distant metastasis and distant metastasis, respectively, revealing a statistically significant difference (P<0.01). Echocardiography findings revealed no significant difference between patients with and without distant metastasis. The correlation coefficient between cardiac SUVmax and total tumor volume on PET/CT images (primary + lymph + distant metastases) was statistically significant (r=-0.42, P=0.03). Analysis of the association between the occurrence of distance metastasis and cardiac SUVmax as a continuous variable gave a statistically significant result [hazard ratio (HR): 0.30, 95% confidence interval (CI): 0.09-0.98, P=0.045]. Receiver operating characteristic analysis showed a cardiac SUVmax of 2.6 with an area under the curve of 0.86 for determining the presence of distant metastasis (95% CI: 0.70-1.00). The median observation time was 56 months, and nine patients died during observation. Analysis of the association between the overall survival and cardiac SUVmax (cutoff: 2.6) showed 95% CI: 0.01-0.45 and HR: 0.06 (P<0.01); that between the overall survival and total tumor volume on PET images showed 95% CI: 1.00-1.00 and HR: 1.00 (P<0.01); and that between the overall survival and presence of distant metastasis showed 95% CI: 1.72-116.4 and HR: 14.1 (P<0.01). Furthermore, 25 patients (16 men and nine women) aged 71.4±14.2 years with new-onset colon cancer were selected for the study. Analysis of new-onset colon cancer revealed no statistically significance between the cardiac SUVmax and distant metastasis.
本研究旨在调查18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）检查新发直肠癌和新发结肠癌（升结肠癌、横结肠癌、降结肠癌、乙状结肠癌）时影响心脏摄取18F-FDG的因素，并研究18F-FDG心脏摄取与预后之间的关联。研究对象为2013年1月1日至2018年3月31日期间在日本伊贺市综合医院被诊断为新发直肠癌和新发结肠癌（升结肠癌、横结肠癌、降结肠癌、乙状结肠癌）的患者，他们均接受了18F-FDG PET扫描以进行治疗前分期。研究了心脏最大标准摄取值（SUVmax）、远处转移的有无与预后之间的关系。本研究共纳入26例年龄为72.0±10岁的新发直肠癌患者（14例男性和12例女性）。无患者同时患有多种癌症。无远处转移和有远处转移患者的心脏SUVmax中位数分别为3.8和2.5，差异具有统计学意义（P<0.01）。PET计算机断层扫描（CT）图像上肿瘤体积中位数在无远处转移和有远处转移患者中分别为7815 cm和66248 cm，差异具有统计学意义（P<0.01）。超声心动图检查结果显示，有远处转移和无远处转移患者之间无显著差异。PET/CT图像（原发灶+淋巴结+远处转移灶）上心脏SUVmax与肿瘤总体积之间的相关系数具有统计学意义（r=-0.42，P=0.03）。将远处转移的发生与作为连续变量的心脏SUVmax之间的关联进行分析，结果具有统计学意义[风险比（HR）：0.30，95%置信区间（CI）：0.09-0.98，P=0.045]。受试者工作特征分析显示，用于确定远处转移存在的心脏SUVmax为2.6，曲线下面积为0.86（95%CI：0.70-1.00）。中位观察时间为56个月，9例患者在观察期间死亡。对总生存期与心脏SUVmax（临界值：2.6）之间的关联进行分析，结果显示95%CI：0.01-0.45，HR：0.06（P<0.01）；总生存期与PET图像上肿瘤总体积之间的关联显示95%CI：1.00-1.00，HR：1.00（P<0.01）；总生存期与远处转移的存在之间的关联显示95%CI：1.72-116.4，HR：14.1（P<0.01）。此外，本研究还纳入了25例年龄为71.4±14.2岁的新发结肠癌患者（16例男性和9例女性）。对新发结肠癌的分析显示，心脏SUVmax与远处转移之间无统计学意义。
