Kandemir Ozan, Demir Fadime
Department of Nuclear Medicine, Faculty of Medicine, Sıtkı Kocman University, Mugla, Turkey.
Nuclear Medicine Department, Kayseri City Health Application and Research Center, Health Sciences University, Kayseri, Turkey.
Curr Radiopharm. 2024;17(1):111-116. doi: 10.2174/1874471016666230829100703.
Mediastinal lymph node metastasis is an important prognostic factor in non-small cell lung cancer (NSCLC) patients without distant metastases. F-2-fluoro-2-deoxy-Dglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) is recommended for detecting and staging lymph nodes and distant metastases in NSCLC patients.
This study aims to investigate whether maximum standardized uptake (SUVmax), mean standardized uptake (SUVmean), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG) values of the primary tumor measured by F-FDG PET/CT in resectable NSCLC can predict preoperative lymph node metastasis.
This retrospective study included eighty NSCLC patients who underwent preoperative Positron Emission Tomography/Computed Tomography (PET/CT) for diagnosis and staging. The patients were stage I-III and had no distant metastases. Tumor metabolic parameters such as SUVmax, SUVmean, MTV, and TLG at PET/CT imaging were measured for preoperative diagnosis and staging, and the postoperative pathology results of the patients were examined. The pathology results divided patients with and without lymph node metastasis into two groups. The groups were compared with the student's t-test and chi-square test regarding F-FDG PET/CT tumor metabolic parameters and other parameters.
Fifteen (18.8%) patients were female, and 65 (81.3%) were male. According to the postoperative pathology results, while 30 (37.5%) patients had lymph node metastasis, 50 (62.5%) did not. There was a significant difference between the groups regarding tumor SUVmax and SUVmean values (p = 0.036, p = 0.045). Overall survival in the N0 group was significantly higher than in the N1 + N2 group (p = 0.034); median survival was 30.2 months in N0 cases and 27.3 months in N1 and N2 groups.
SUVmax and SUVmean values are significantly higher in patients with lymph node metastases than in patients without lymph node metastases, and this finding may provide useful information for predicting lymph node metastasis in patients with resectable NSCLC.
纵隔淋巴结转移是无远处转移的非小细胞肺癌（NSCLC）患者的一个重要预后因素。推荐使用F-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）来检测NSCLC患者的淋巴结及远处转移并进行分期。
本研究旨在探讨F-FDG PET/CT测量的可切除NSCLC原发肿瘤的最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）和肿瘤病灶糖酵解（TLG）值是否能够预测术前淋巴结转移。
这项回顾性研究纳入了80例接受术前正电子发射断层扫描/计算机断层扫描（PET/CT）以进行诊断和分期的NSCLC患者。患者为Ⅰ-Ⅲ期且无远处转移。在PET/CT成像时测量肿瘤代谢参数，如SUVmax、SUVmean、MTV和TLG，用于术前诊断和分期，并检查患者的术后病理结果。病理结果将有或无淋巴结转移的患者分为两组。就F-FDG PET/CT肿瘤代谢参数及其他参数而言，采用学生t检验和卡方检验对两组进行比较。
15例（18.8%）患者为女性，65例（81.3%）为男性。根据术后病理结果，30例（37.5%）患者有淋巴结转移，50例（62.5%）没有。两组之间的肿瘤SUVmax和SUVmean值存在显著差异（p = 0.036，p = 0.045）。N0组的总生存期显著高于N1 + N2组（p = 0.034）；N0组的中位生存期为30.2个月，N1和N2组为27.3个月。
有淋巴结转移患者的SUVmax和SUVmean值显著高于无淋巴结转移患者，这一发现可能为预测可切除NSCLC患者的淋巴结转移提供有用信息。
