Objective:To investigate whether 68Ga-FAP-2286 positron emission tomography(PET)/computed tomography(CT)could identify patients with advanced digestive malignancies with shorter overall survival(OS)compared to clinical parameters.Methods:The imaging data and clinical data of patients with advanced digestive system tumors confirmed by histopathological examination in the Affiliated Hospital of Southwest Medical University from April 2023 to June 2024 who underwent 68Ga-FAP-2286 PET/CT examination after surgical treatment,chemoradiotherapy and targeted immunotherapy were retrospectively analyzed.Scans were assessed visually and quantitatively by manually segmenting the tumor load[calculating tumor volume,peak/mean/maximum standardized uptake value(SUV),tumor-to-background ratio(TBR),and tumor receptor binding(TRB)on the cell surface,defined as SUVmean multiplied by tumor volume].Clinical parameters included gender,prior treatment and age.After imaging,OS was recorded.Results:A total of 32 patients,22 males and 10 females,aged 30-83 years,were included in this study.In univariate COX regression analysis,higher TBR(HR=1.217,95%CI 1.022-1.448,P=0.027),higher TRB(HR=1.001,95%CI 1.000-1.002,P=0.029)and the presence of lymph node metastasis(HR=3.783,95%CI 1.033-13.854,P=0.045)were significantly associated with shorter OS.Larger tumor volume had a significant trend(HR=1.004,95%CI 1.000-1.009,P=0.066),while other parameters could not predict OS.In multivariate COX regression,only TRB was identified as an important independent prognostic factor for OS(HR=1.001,95%CI 1.000-1.003,P=0.018).In Kaplan-Meier analysis,TRB higher than median 142,TBR higher than median 8.3 and lymph node metastasis were associated with shorter OS.Conclusion:In advanced digestive system malignancies,elevated TRB detected by 68Ga-FAP-2286 PET/CT was an independent predictor of OS.
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