摘要
目的 探讨18F-FDG PET/CT代谢参数及代谢异质性指数对胃腺癌患者新辅助化疗疗效的预测价值.方法 回顾性分析107例接受新辅助化疗的胃癌患者.搜集患者的临床信息、治疗前18F-FDG PET/CT图像、术后病理结果.测量原发灶的SUVmax1、SUVmean1、MTV、TLG、肝脏的SUVmax2和SUVmean2,计算异质性指数-1(HI-1)、异质性指数-2(HI-2)及肿瘤肝脏摄取比(TLR),分析这些半定量参数及患者临床数据特征与患者化疗后反应(肿瘤消退分级)的相关性.结果 不同肿瘤消退分级组间T分期、M分期、脉管侵犯情况、神经侵犯情况、SUVmax1、SUVmean1、MTV、TLG、HI-1、HI-2 及 TLR 差异有统计学意义(P＜0.05).在多因素分析中,SUVmax1、SUVmean1水平、存在远处转移及存在脉管侵犯是预测新辅助化疗疗效的独立危险因素.结论 18F-FDG PET/CT代谢参数结合临床特征可以一定程度预测胃腺癌患者新辅助化疗的疗效.
Abstract
Objective Exploring the predictive value of 18F-FDG PET/CT metabolic parameters and metabolic heteroge-neity index for the efficacy of neoadjuvant chemotherapy in patients with gastric adenocarcinoma.Methods Retrospective analysis of 107 gastric cancer patients receiving neoadjuvant chemotherapy.Collect clinical information of patients,pre treatment 18F-FDG PET/CT images,and postoperative pathological results.Measure the SUVmax1,SUVmean1,MTV,TLG of the primary lesion,SUVmax2 and SUVmean2 of the liver.Calculate heterogeneity index-1(HI-1),heterogeneity index-2(HI-2),and tumor liver uptake ratio(TLR).Analyze the correlation between these semi quantitative parameters and clinical data characteristics of patients with postoperative chemotherapy response(TRG).Results There were statis-tically significant differences(P＜0.05)in T stage,M stage,vascular invasion,nerve invasion,SUVmax1,SUVmean1,MTV,TLG,HI-1,HI-2,and TLR among the same TRG grading group.In multivariate analysis,SUVmax1 and SU-Vmean1 levels,the presence of distant metastasis,and vascular invasion were independent risk factors for predicting the ef-ficacy of neoadjuvant chemotherapy.Conclusion The combination of 18F-FDG PET/CT metabolic parameters and clinical characteristics can predict the efficacy of neoadjuvant chemotherapy in patients with gastric adenocarcinoma to a certain ex-tent.
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