Zheng Cheng, Miao Jiangfeng, Xu LiuWei, Cai Yujie, Zheng BingShu, Tan ZhongHua, Sun ChunFeng
Department of Nuclear Medicine, Affiliated Hospital of Nantong University, ChongChuan District, No. 20 of Xisi Road, ChongChuan District, Nantong City, Jiangsu, 226001, China.
BMC Cancer. 2025 May 14;25(1):874. doi: 10.1186/s12885-025-14263-0.
The exploration of biomarkers is of crucial importance for the prognosis of cancer patients. The objective of this study was to ascertain the predictive value of positron emission tomography (PET) image-derived biomarkers, specifically the normalized distances from the hot spot of radiotracer uptake to the tumor centroid (NHOC) and the tumor perimeter (NHOP), in forecasting the recurrence risk and disease-free survival (DFS) in patients with operable stage IA-IIIA lung adenocarcinoma (LUAD).
A retrospective analysis was conducted on 164 patients with surgically treated pathologically confirmed stage IA-IIIA LUAD, all of whom had prior F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (F-FDG PET/CT) scans. In addition to conventional PET/CT parameters, we assessed the normalized distances from the maximum SUV to both the tumor centroid (NHOCmax) and the tumor perimeter (NHOPmax) as observed in the PET/CT images.
A total of 164 patients were included, with a median age of 65 years. NHOPmax exhibited the highest AUC of 0.682 (95% CI: 0.578-0.785), with a sensitivity of 78.8%. Correlation analysis showed that NHOPmax had low correlations with other metabolic parameters such as SUVmax, TLG, and MTV. In both univariate and multivariate analyses, NHOPmax was significantly associated with postoperative outcomes (P < 0.001, odds ratio 0.033). Survival analysis indicated that NHOPmax was an independent predictor of DFS (HR = 0.399, P < 0.05), with higher NHOPmax (> 0.43) associated with significantly better survival (P < 0.0001).
NHOPmax quantified from F-FDG PET/CT scans, could be a promising predictor of postoperative recurrence in patients with resectable LUAD.
生物标志物的探索对癌症患者的预后至关重要。本研究的目的是确定正电子发射断层扫描（PET）图像衍生的生物标志物的预测价值，特别是从放射性示踪剂摄取热点到肿瘤质心（NHOC）和肿瘤周长（NHOP）的归一化距离，以预测可手术的IA-IIIA期肺腺癌（LUAD）患者的复发风险和无病生存期（DFS）。
对164例经手术治疗且病理确诊为IA-IIIA期LUAD的患者进行回顾性分析，所有患者均有术前F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）。除了传统的PET/CT参数外，我们还评估了PET/CT图像中观察到的从最大SUV到肿瘤质心（NHOCmax）和肿瘤周长（NHOPmax）的归一化距离。
共纳入164例患者，中位年龄65岁。NHOPmax的AUC最高，为0.682（95%CI：0.578-0.785），敏感性为78.8%。相关性分析表明，NHOPmax与其他代谢参数如SUVmax、TLG和MTV的相关性较低。在单因素和多因素分析中，NHOPmax均与术后结果显著相关（P<0.001，比值比0.033）。生存分析表明，NHOPmax是DFS的独立预测因子（HR=0.399，P<0.05），较高的NHOPmax（>0.43）与显著更好的生存率相关（P<0.0001）。
从F-FDG PET/CT扫描中量化的NHOPmax可能是可切除LUAD患者术后复发的有前景的预测因子。
