摘要
目的:探讨18F-FDG PET/CT相关代谢参数对儿童神经母细胞瘤(NB)MYCN基因扩增的预测价值及预后评估.方法:回顾性选取2019年1月至2022年12月期间65例NB儿童作为研究对象,所有患儿均在治疗前进行了 18F-FDG PET/CT诊断及经手术病理确诊.记录患儿MYCN基因扩增状态,测量病灶不同的PET代谢参数,包括最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、代谢肿瘤体积(MTV)及病灶糖酵解总量(TLG),随访内容包括肿瘤进展、复发及死亡并记录时间.采用Kaplan-Meier生存曲线分析MYCN基因扩增与NB进展、复发及死亡之间的相关性,比较各参数在MYCN基因扩增与未扩增组间差异.使用ROC曲线确定PET代谢参数预测MYCN扩增的最佳临界值.采用Cox模型进行多因素预后分析.结果:本组MYCN基因扩增与NB进展、复发相关(x2=8.478,P=0.004;x2=6.326,P=0.012).PET代谢参数SUVmax、SUVmean及 TLG 与 MYCN基因扩增有显著相关性(均为P＜0.05),预测MYCN基因扩增最佳临界值分别为5.55、4.45及929.10.SUVmax与NB进展显著相关,SUVmax、SUVmean、TLG与复发显著相关,SUVmax与死亡显著相关(均为P＜0.05).结论:NB患儿治疗前18F-FDG PET/CT的SUVmax＞5.55、SUVmean＞4.45及TLG＞929.1,极有可能伴有MYCN扩增,可作为NB进展、复发预测指标之一.
Abstract
Objective:To investigate the predictive value and prognostic assessment of 18F-FDG PET/CT metabolic parameters for MYCN gene amplification in pediatric neuroblastoma(NB).Methods:A total of 65 cases of NB confirmed by pathology and examined by 18F-FDG PET/CT from January 2019 to December 2022 were retrospectively selected as the research objects.The MYCN gene amplification status of the children was recorded,and different PET metabolic parameters(SUVmax,SUVmean,MTV,and TLG)of the lesions were measured.Follow-up information included tumor progression,recurrence,and death,as well as their time-points,were recorded.The correlation between MYCN gene amplification and NB progression,recurrence,and death was analyzed using Kaplan-Meier sur-vival curves,and the differences in each parameter were compared between the MYCN gene amplified and unamplified groups.ROC curves were used to determine the optimal threshold values for PET/CT metabolic parameters to predict MYCN amplification.Multifactorial prognostic analysis was per-formed using the Cox model.Results:In this group,MYCN gene amplification was correlated with NB progression and recurrence(x2=8.478,P=0.004;x2=6.326,P=0.012).SUVmax,SUVmean,and TLG were significantly correlated with MYCN gene amplification(all P＜0.05).The predicted optimal thresholds for MYCN gene amplification SUVmax,SUVmean,and TLG were 5.55,4.45,and 929.10,respectively.SUVmax was significantly correlated with the progression of NB,SUVmax,and SUVmean,TLG were significantly correlated with recurrence,and SUVmax was significantly correlated with death(all P＜0.05).Conclusion:Pre-treatment 18F-FDG PET/CT SUVmax＞5.55,SUVmean＞4.45,and TLG＞929.1 in pediatric NB are highly likely to be accompanied by MYCN amplification and serve as the predictors of progression and recurrence for the disease.
NETL
NSTL
万方数据