镓 FAPI-04 PET/CT 在非小细胞肺癌中的应用:准确评估淋巴结转移及与成纤维细胞激活蛋白表达的相关性。
Ga-FAPI-04 PET/CT in Non-Small Cell Lung Cancer: Accurate Evaluation of Lymph Node Metastasis and Correlation with Fibroblast Activation Protein Expression.
机构信息
Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China; and.
出版信息
J Nucl Med. 2024 Apr 1;65(4):527-532. doi: 10.2967/jnumed.123.266806.
Fibroblast activation protein (FAP) is a promising diagnostic and therapeutic target in various solid tumors. This study aimed to assess the diagnostic efficiency of Ga-labeled FAP inhibitor (FAPI)-04 PET/CT for detecting lymph node metastasis in non-small cell lung cancer (NSCLC) and to investigate the correlation between tumor Ga-FAPI-04 uptake and FAP expression. We retrospectively enrolled 136 participants with suspected or biopsy-confirmed NSCLC who underwent Ga-FAPI-04 PET/CT for initial staging. The diagnostic performance of Ga-FAPI-04 for the detection of NSCLC was evaluated. The final histopathology or typical imaging features were used as the reference standard. The SUV and SUV, Ga-FAPI-avid tumor volume (FTV), and total lesion FAP expression (TLF) were measured and calculated. FAP immunostaining of tissue specimens was performed. The correlation between Ga-FAPI-04 uptake and FAP expression was assessed using the Spearman correlation coefficient. Ninety-one participants (median age, 65 y [interquartile range, 58-70 y]; 69 men) with NSCLC were finally analyzed. In lesion-based analysis, the diagnostic sensitivity and positive predictive value of Ga-FAPI-04 PET/CT for detection of the primary tumor were 96.70% (88/91) and 100% (88/88), respectively. In station-based analysis, the diagnostic sensitivity, specificity, and accuracy for the detection of lymph node metastasis were 72.00% (18/25), 93.10% (108/116), and 89.36% (126/141), respectively. Tumor Ga-FAPI-04 uptake (SUV, SUV, FTV, and TLF) correlated positively with FAP expression ( = 0.470, 0.477, 0.582, and 0.608, respectively; all ≤ 0.001). The volume parameters FTV and TLF correlated strongly with FAP expression in 31 surgical specimens ( = 0.700 and 0.770, respectively; both < 0.001). Ga-FAPI-04 PET/CT had excellent diagnostic efficiency for detecting lymph node metastasis, and Ga-FAPI-04 uptake showed a close association with FAP expression in participants with NSCLC.
成纤维细胞激活蛋白(FAP)是各种实体瘤有前途的诊断和治疗靶点。本研究旨在评估 Ga 标记的 FAP 抑制剂(FAPI)-04 PET/CT 检测非小细胞肺癌(NSCLC)淋巴结转移的诊断效能,并探讨肿瘤 Ga-FAPI-04 摄取与 FAP 表达之间的相关性。我们回顾性纳入了 136 名疑似或经活检证实为 NSCLC 且接受 Ga-FAPI-04 PET/CT 初始分期的参与者。评估了 Ga-FAPI-04 检测 NSCLC 的诊断性能。最终的组织病理学或典型影像学特征被用作参考标准。测量和计算了 SUV 和 SUV,Ga-FAPI- 阳性肿瘤体积(FTV)和总病变 FAP 表达(TLF)。对组织标本进行 FAP 免疫组化染色。使用 Spearman 相关系数评估 Ga-FAPI-04 摄取与 FAP 表达之间的相关性。最终分析了 91 名参与者(中位年龄 65 岁[四分位距 58-70 岁];69 名男性)的 NSCLC。在基于病灶的分析中,Ga-FAPI-04 PET/CT 检测原发性肿瘤的诊断敏感性和阳性预测值分别为 96.70%(88/91)和 100%(88/88)。在基于站的分析中,检测淋巴结转移的诊断敏感性、特异性和准确性分别为 72.00%(18/25)、93.10%(108/116)和 89.36%(126/141)。肿瘤 Ga-FAPI-04 摄取(SUV、SUV、FTV 和 TLF)与 FAP 表达呈正相关( = 0.470、0.477、0.582 和 0.608,均 ≤ 0.001)。31 份手术标本中 FTV 和 TLF 与 FAP 表达呈强相关( = 0.700 和 0.770,均 < 0.001)。Ga-FAPI-04 PET/CT 对检测淋巴结转移具有出色的诊断效能,且 NSCLC 患者中 Ga-FAPI-04 摄取与 FAP 表达密切相关。