原发灶18F-FDG PET/CT肿瘤代谢体积与晚期非小细胞肺癌患者预后的相关性研究

摘要

Purpose To evaluate the correlation between the metabolic tumor volume (MTV) of 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of primary lesions and the prognosis in patients with advanced non small cell lung cancer (NSCLC) . Materials and methods One hundred and ten patients with advanced NSCLC underwent 18F-FDG PET/CT scan were recruited in this study consecutively from January 2005 to December 2007. All the patients developed NSCLC with pathological stage on Ⅲ or Ⅳ and received treatment by radiation and chemotherapy. A 2-year follow-up was conducted after treatment for all the patients. The survival rate analysis was determined by Kaplan-Meier survival curve and log-rank test.The prognostic significance of MTV, SUVmax, and other clinical-pathological variables were calculated by Cox proportional hazards regression analysis. A time-dependent receiver operating characteristic curve (ROC) was utilized to compare the power of MTV and SUV max in predicting patient's prognosis. Results The overall two-year-survival of the patients was 20.9％ after treatment. On time-dependent ROC analysis, MTV showed greater AUC value as compared to SUVmax in predicting prognosis (0.649 vs.0.523). While the cut-off point of MTV was set as 33.8cm3, a significantly higher 2-year survival rate was observed in patients with smaller MTV as compared to patients with larger MTV (5.9％ vs. 27.6％, P＜0.05). In the univariate and multivariate analyses,clinical stage, MTV and pathological types of primary tumors were significant predictors for 2-year survival rate. Conclusions The MTV measurement of primary lesions is significantly associated with prognosis in patients with advanced NSCLC. Advanced NSCLC patients with larger MTV may have lower survival rate.%目的 探讨晚期非小细胞肺癌(NSCLC)原发灶18F-FDG PET/CT肿瘤代谢活性体积(MTV)与预后的关系.资料与方法 回顾性分析治疗前行PET/CT检查的110例均经病理或细胞学证实的Ⅲ、Ⅳ期NSCLC患者,所有患者均接受同步放、化综合治疗,治疗后随访2年以上,并用Kaplan-Meier法、Log-rank检验及Cox比例风险模型分析MTV及标准摄取值(SUV)与预后的关系,ROC曲线比较MTV与SUVmax预测患者预后的能力.结果 全组患者2年总生存率为20.9%,ROC曲线分析显示,MTV与SUV预测预后的曲线下面积分别为0.649和0.523;MTV≤33.8cm3与MTV＞33.8cm3患者2年生存率分别为27.6%和5.9%,差异具有统计学意义(P＜0.05);单因素及多因素分析均显示,2年生存率与MTV、临床分期、病理类型有关(P＜0.05).结论 晚期NSCLC原发灶MTV与患者的预后相关,MTV较大者,患者的生存期较短.