Department of Thoracic Surgery, Kanazawa Medical University, Uchinada, Japan.
Oncology. 2023;101(8):473-480. doi: 10.1159/000530314. Epub 2023 Jul 11.
Although the consolidation diameter of a tumor on computed tomography (CT) is an adaptation criterion for limited resection in early-stage non-small cell lung cancer (NSCLC), whether the maximum standardized uptake value (SUVmax) is also an adaptation criterion for limited resection has not been evaluated.
In total, 478 NSCLC patients with clinical stage IA disease were analyzed, among whom 383 were used to perform a sub-analysis.
Multivariate analysis showed that consolidation diameter (odds ratio [OR]: 3.05, p = 0.01), SUVmax (OR: 10.74, p = 0.02), and lymphatic invasion (OR: 10.34, p < 0.01) were risk factors for lymph node metastasis in clinical stage IA NSCLC patients. Furthermore, age (OR: 2.98, p = 0.03), SUVmax (OR: 13.07, p = 0.02), and lymphatic invasion (OR: 5.88, p = 0.02) were risk factors for lymph node metastasis in clinical stage IA lung adenocarcinoma patients according to multivariate analysis.
Consolidation diameter of a tumor on CT, SUVmax, and lymphatic invasion are risk factors for lymph node metastasis. However, SUVmax was a risk factor for lymph node metastasis rather than consolidation diameter on CT in lung adenocarcinoma patients. These results suggest that for early-stage lung adenocarcinoma patients, SUVmax is more important for deciding the indication of limited resection than consolidation diameter of the tumor on CT.
虽然计算机断层扫描（CT）上肿瘤的实变直径是早期非小细胞肺癌（NSCLC）局限性切除的适应标准，但最大标准化摄取值（SUVmax）是否也是局限性切除的适应标准尚未得到评估。
共分析了 478 例临床ⅠA 期 NSCLC 患者，其中 383 例进行了亚分析。
多因素分析显示，实变直径（比值比 [OR]：3.05，p = 0.01）、SUVmax（OR：10.74，p = 0.02）和淋巴管浸润（OR：10.34，p < 0.01）是临床ⅠA 期 NSCLC 患者淋巴结转移的危险因素。此外，多因素分析显示，年龄（OR：2.98，p = 0.03）、SUVmax（OR：13.07，p = 0.02）和淋巴管浸润（OR：5.88，p = 0.02）是临床ⅠA 期肺腺癌患者淋巴结转移的危险因素。
CT 上肿瘤的实变直径、SUVmax 和淋巴管浸润是淋巴结转移的危险因素。然而，SUVmax 是肺腺癌患者淋巴结转移的危险因素，而不是 CT 上肿瘤的实变直径。这些结果表明，对于早期肺腺癌患者，SUVmax 对于决定局限性切除的适应证比 CT 上肿瘤的实变直径更重要。
