首页|18F-FDG PET/CT原发灶代谢参数对肺腺癌临床分期的预测价值

18F-FDG PET/CT原发灶代谢参数对肺腺癌临床分期的预测价值

Value of 18F-FDG PET/CT metabolic parameters of the primary tumor for predicting clinical stage in lung adenocarcinoma

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
目的:探讨基于18F-脱氧葡萄糖(FDG)PET/CT代谢参数对肺腺癌临床分期的预测价值.方法:回顾性分析经病理确诊的86例肺腺癌患者的临床和影像资料.86例中早期组54例,进展期组32例.测量原发灶最大径、最大标准化摄取值(SUVmax)、平均标准摄取值(SUVmean),以相对阈值法(40%为阈值)测量肿瘤代谢体积(MTV)及糖酵解总量(TLG).采用单因素及多因素logistic回归分析对进展期肺腺癌的危险因素进行分析,并生成相应的预测模型.通过ROC曲线分析各参数及模型预测进展期肺腺癌的价值.结果:进展期组中央型肺癌、有肺癌相关症状、血清癌胚抗原(CEA)≥5.00 μg/L的构成比,以及原发灶最大径、SUVmax、MTV、TLG均大于早期组,差异均有统计学意义(均P<0.01).多因素分析显示,有肺癌相关症状、血清CEA≥5.00 μg/L、SUVmax均为进展期肺腺癌的独立危险因素(均P<0.01).ROC曲线分析显示,各代谢参数对进展期肺腺癌均有良好的预测效能,其中以TLG的AUC最大,达0.782,最佳界值为14.27 g,敏感度为90.6%,特异度为61.1%.logistic回归模型诊断进展期肺腺癌的AUC为0.854(95%CI 0.773～0.934),敏感度、特异度和准确率分别为78.1%、79.6%和79.0%.结论:18F-FDG PET/CT原发灶代谢参数对进展期肺腺癌具有良好的预测效能,联合临床特征能提高对肺腺癌临床分期的诊断效能,为临床提供指导.
Objective:To investigate the value of 18F-FDG PET/CT metabolic parameters of the primary tumor for predicting clinical stage in lung adenocarcinoma.Methods:The clinical and imaging data of 86 patients with lung adenocarcinoma were retrospectively analyzed.86 cases were divided into the early-stage group(54 cases)and the advanced-stage group(32 cases).The maximum diameter,SUVmax,SUVmean of the primary tumor were measured.Metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were calculated by the relative threshold method(40%).The risk factors of advanced-stage lung cancer were determined through univariate and multivariate logistic regression analysis,and the prediction models were built.The ROC curve was used for the value of each parameter in predicting advanced-stage lung cancer.Results:The proportion of patients who had central primary lesions and symptoms,the proportion of CEA≥5.00 ng/mL,the maximum diameter,SUVmax,MTV,TLG of the primary tumor in the advanced-stage group were significantly higher than those in early-stage group(all P<0.01).The multivariate analysis showed that symptoms,CEA≥5.00 ng/mL and SUVmax were the independent risk factors in advanced-stage adenocarcinoma(all P<0.01).ROC curve showed that all parameters had important values for the evaluation of advanced-stage adenocarcinoma.The best diagnostic efficiency was TLG with the AUC of 0.782,the optimal cut-off value of 14.27 g,the sensitivity of 90.6%and the specificity of 61.1%.The AUC of the logistic regression model in diagnosis of advanced-stage adenocarcinoma was 0.854(95%CI 0.773～0.934),with the sensitivity,specificity and accuracy of 78.1%,79.6%and 79.0%,respectively.Conclusions:18F-FDG PET/CT metabolic parameters of the primary tumor have an important value in the prediction for advanced-stage adenocarcinoma.18F-FDG PET/CT combined with clinical features can improve the diagnostic efficiency of clinical staging of lung cancer and provide more accurate guidance for clinic.

Lung adenocarcinomaPositron emission tomographyTomography,X-ray computedMetabolic parametersStage

朱俊辉、李思叶、黄子康、王静、周伟、陈薏帆、朱玉春

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江苏大学附属昆山医院/江苏省昆山市第一人民医院核医学科,江苏 昆山 215300

南京医科大学姑苏学院,江苏 苏州 215002

江苏大学医学院,江苏 镇江 212013

肺腺癌 正电子发射断层成像 体层摄影术,X线计算机 代谢参数 分期

江苏大学2023年度医教协同创新基金一般项目昆山市第一人民医院2022年度广仁基金科研课题(临床研究专项)重点项目2023年昆山市重点研发计划(社会发展)指导性项目

JDYY2023060KRY-YN2022001KSZ2311

2024

10.3969/j.issn.1672-0512.2024.03.015

中国中西医结合影像学杂志
中国中西医结合学会,山东中医药大学附属医院

中国中西医结合影像学杂志

CSTPCD
影响因子：0.857
ISSN：1672-0512
年,卷(期)：2024.22(3)
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