Value of 18F-FDG PET/CT imaging characteristics of primary lesions in predicting lymph node metastasis of non-small cell lung cancer
Objective To explore the influencing factors of lymph node metastasis in non-small cell lung cancer(NSCLC)based on 18F-fluorodeoxyglucose(18F-FDG)positron emission tomography imaging/computed tomography imaging(PET/CT),to establish a Logistic prediction model and to analyze its predictive clinical value.Methods One hundred and fifty-six patients with NSCLC admitted to our hospital from June 2019 to June 2021 were collected as observation subjects,and they were divided into 47 cases in the combined lymph node metastasis group and 109 cases in the uncomplicated lymph node metastasis group according to whether they had combined lymph node metastasis,the clinicopathological characteristics of the two groups were compared.All of them performed an 18F-FDG PET/CT examination,the imaging characteristics of primary foci such as SUVmax,total glycolysis(TLG),and metabolic volume(MTV)were compared between the two groups and a Logistic regression equation was established:P=ExpΣBiXi/1+ExpΣBiXi,and a Logistic prediction model was established and analyzed for its sensitivity,specificity and accuracy of predicting lymph node metastasis.Results The proportion of TNM stage Ⅲ and tumor diameter≥3 cm was significantly higher in the lymph node metastasis group than that in the no lymph node metastasis group(P＜0.05).The indexes of T-SUVmax,T-TLG,L-SURmax,T-TLGsur,B-SURmax,B-TLGsur in the primary foci of patients with lymph node metastasis were higher than those in the group without lymph node metastasis,and the difference was statistically significant(P＜0.05).The results of Logistic regression analysis suggested that TNM stage,tumor diameter,T-SUVmax,T TLG,L-SURmax,T-TLGsur,B-SURmax,and B-TLGsur indicators were all associated with lymph node metastasis in NSCLC(P＜0.05).The probability P of lymph node metastasis in NSCLC was predicted by a Logistic regression model,and the receiver operator characteristic curve(ROC)of P value was established,and the area under the curve(AUC)of the model predicting the probability P was 0.796(0.693,0.899),suggesting that the model has a high utility value.When the sensitivity was 89.5％,the specificity was 69.0％,and the Jorden index was 0.585,the corresponding predictive probability was-3.258.Conclusion 18F-FDG PET/CT imaging features of the primary lesion of lymph node metastasis in NSCLC are obviously abnormally expressed,and the establishment of predictive model can further improve the diagnostic efficacy of lymph node metastasis in NSCLC patients,which can be clinically selected for more aggressive treatment options.
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