18F-FDG uptake as a biologic factor predicting outcome in patients with resected non-small-cell lung cancer

摘要

＜正＞ Background The outcome of surgical treatment of non-small-cell lung cancer （NSCLC） remains poor.In many patientsthe biological behavior of NSCLC does not follow a definite pattern,and can not be accurately predicted before treatment.18F-fluoro-2-deoxy-glucose (18F-FDG) uptake on positron-emission tomography （PET） is associated with theaggressiveness of NSCLC.The present study focused on the role of 18SF-FDG uptake in predicting the outcome ofsurgically treated patients with NSCLC.Methods A retrospective analysis was made of 82 patients who underwent complete resection and preoperative FDGPET.The maximum standardized uptake value （SUVmax）,in addition to five clinicopathological factors and threebiomolecular factors,which could possibly influence survival,was compared for possible association with patients’recurrence and survival,by the Log-rank test in univariate analysis and the Cox proportional hazards model inmultivariate analysis.The association between SUVmax and other factors was also analyzed.Results Patients with SUVmax more than 11 had a disease-free survival and overall survival shorter than patients withSUVmax less than 11 in univariate analyses （P＜0.001,P=0.002）.In the multivariate analysis,SUVmax （dichotomized by 11）was the only significant predictor for tumor recurrence.TNM stage and SUVmax （dichotomized by 11） were independentpredictors for the overall survival.Associations of SUVmax with p53 overexpression,proliferating cell nuclear antigen（PCNA） labeling index and microvascular density of the tumor were significant in the entire group.Conclusions 18F-FDG uptake on PET may be used to noninvasively assess biological aggressiveness of NSCLC invivo,identifying the surgically-treated patients with poor prognosis who could benefit from additional therapy.