代谢 18F-FDG PET/CT 参数和血液学预后指标在结直肠癌患者中的预后作用。

Prognostic role of metabolic 18F-FDG PET/CT parameters and hematological prognostic indicators in patients with colorectal cancer.

机构信息

Department of Nuclear Medicine, Aydın Adnan Menderes University Medical School, Aydın, Turkey.

Department of Medical Oncology, Aydın Adnan Menderes University Medical School, Aydın, Turkey.

出版信息

Indian J Cancer. 2023 Apr-Jun;60(2):224-229. doi: 10.4103/ijc.IJC_1029_20.

DOI:10.4103/ijc.IJC_1029_20

PMID:37530245

Abstract

BACKGROUND

The aim of this study is to evaluate the role of preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) parameters, including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), hematologic prognostic indicators in patients with colorectal cancer (CRC) in terms of predicting prognosis.

METHODS

One hundred and one patients who had undergone 18F-FDG PET/CT for initial staging were evaluated retrospectively. Patient data including pathologic stage at presentation, histology, tumor location, and overall survival (OS) were analyzed. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), serum carcinoembryonic antigen (CEA) (ng/mL), CA-125 (cancer antigen 125) (U/mL), and CA19-9 (U/mL) levels, which were obtained within 2 weeks of the PET/CT examination, were used for hematological data.

RESULTS

The TNM Classification of Malignant Tumors stage and PET/CT parameters, including SUVmax, MTV, and TLG, were found to be correlated with survival rate in univariate analysis (P < 0.05). All hematological markers excluding PLR were also significantly associated with survival time. Receiver operating characteristics (ROC) analysis revealed that the optimal SUVmax cutoff value for predicting survival time in patients with CRC was >17.9 (Area under curve (AUC) = 0.625; P < 0.05). The calculated sensitivity and specificity values for this cutoff were 60% and 65.7%, respectively. To predict the survival time in these patients, the optimal MTV cutoff value was >34.29 (AUC = 0.775; P < 0.001; sensitivity = 85%; specificity = 62.3%). The optimal TLG cutoff value for predicting survival time was >270.4 (AUC = 0.790; P < 0.001; sensitivity = 77.5%; specificity = 68.9%).

CONCLUSIONS

FDG PET/CT metabolical parameters are useful for predicting the prognosis in patients with CRC. High preoperative NLR and high tumor markers were also shown to be negative independent prognostic factors in these patients.

摘要

背景

本研究旨在评估术前 18F-氟代脱氧葡萄糖（FDG）正电子发射断层扫描-计算机断层扫描（PET/CT）参数（包括最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG））、血液学预后指标在预测结直肠癌（CRC）患者预后方面的作用。

方法

回顾性评估了 101 例接受 18F-FDG PET/CT 初始分期的患者。分析了患者的病理分期、组织学、肿瘤位置和总生存期（OS）等数据。在 PET/CT 检查后 2 周内获得的中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、血清癌胚抗原（CEA）（ng/mL）、CA-125（肿瘤抗原 125）（U/mL）和 CA19-9（U/mL）水平用于血液学数据。

结果

单因素分析发现，TNM 恶性肿瘤分期和 PET/CT 参数（包括 SUVmax、MTV 和 TLG）与生存率相关（P < 0.05）。所有血液学标志物（PLR 除外）也与生存时间显著相关。受试者工作特征（ROC）分析显示，CRC 患者 SUVmax 预测生存时间的最佳截断值>17.9（曲线下面积（AUC）= 0.625；P < 0.05）。该截断值的计算敏感性和特异性值分别为 60%和 65.7%。为了预测这些患者的生存时间，MTV 的最佳截断值>34.29（AUC = 0.775；P < 0.001；敏感性= 85%；特异性= 62.3%）。预测生存时间的最佳 TLG 截断值为>270.4（AUC = 0.790；P < 0.001；敏感性= 77.5%；特异性= 68.9%）。