Correlation between combining 18F-FDG PET/CT metabolic parameters and other clinical features and ALK or ROS1 fusion in patients with non-small-cell lung cancer
Correlation between combining 18F-FDG PET/CT metabolic parameters and other clinical features and ALK or ROS1 fusion in patients with non-small-cell lung cancer
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非小细胞肺癌患者18F-FDG PET/CT代谢参数与其他临床特征相结合与ALK或ROS1融合的相关性
DOI：
10.1007/s00259-019-04652-6
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发表时间：
2020-01-03
影响因子：
9.1
通讯作者：
Xie, Wenhui
中科院分区：
文献类型：
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作者：
Ruan, Maomei;Liu, Liu;Xie, Wenhui
目的探讨非小细胞肺癌(NSCLC)F-18-FDG PET/CT代谢参数及其他临床特征与间变性淋巴瘤激酶(ALK)或c-ros癌基因1(ROS1)融合的关系。方法对806例野生型表皮生长因子受体突变患者进行ALK或ROS1融合筛查，治疗前行F-18-FDGPET/CT检查。分析ALK或ROS1融合与临床特征及PET/CT参数的关系。用多因素Logistic回归分析寻找与ALK和ROS1融合相关的独立决定因素。结果82例(11.7%)患者发生ALK融合。多因素分析显示，高pSUVmax=10.6、低原发灶糖酵解(PTLG)和101.8、年轻、不吸烟、高癌胚抗原水平与ALK融合相关。受试者工作特征(ROC)曲线的曲线下面积(AUC值)在高PSUVmax和5种因素联合作用下分别为0.603和0.873。ROS1融合者26例(5.6%)。多变量分析显示，高pSUVmax和gt；=8.8、年轻和非吸烟者状态与非小细胞肺癌ROS1融合相关。ROC曲线显示，仅有高PSUVmax时AUC值为0.662，三种因素联合作用时AUC值为0.813。结论联合F-18-FDG PET/CT代谢参数和其他临床参数与NSCLC患者ALK和ROS1突变相关，有助于优化患者选择和基因检测的过程，用于靶向治疗。
Purpose Our study intended to explore the association between combining F-18-FDG PET/CT metabolic parameters and other clinical features and anaplastic lymphoma kinase (ALK) or c-ros oncogene 1 (ROS1) fusion in non-small-cell lung cancer (NSCLC). Methods Eight hundred and six patients with wild-type epidermal growth factor receptor (EGFR) mutation were screened for ALK or ROS1 fusion and subjected to F-18-FDG PET/CT prior to treatment at our hospital. The associations between ALK or ROS1 fusion and clinical characteristics and the PET/CT parameters were analyzed. Multivariate logistic regression analysis was performed to explore independent deterministic factors associated with ALK and ROS1 fusion. Results Eighty-two patients (11.7%) with ALK fusion were found. Multivariate analysis demonstrated that high pSUVmax >= 10.6, low primary tumor lesion glycolysis (pTLG) < 101.8, young age, nonsmoker status, and high carcinoembryonic antigen (CEA) level correlated with ALK fusion in NSCLC. The receiver operating characteristic (ROC) curve yielded the area under curve (AUC) values of 0.603 and 0.873 for high pSUVmax alone and the combination of the five factors, respectively. Twenty-six patients (5.6%) with ROS1 fusion were found. Multivariate analysis revealed that high pSUVmax >= 8.8, young age, and nonsmoker status correlated with ROS1 fusion in NSCLC. The ROC curve yielded AUC values of 0.662 and 0.813 for high pSUVmax alone and the combination of the three factors, respectively. Conclusion The study indicated that combining F-18-FDG PET/CT metabolic parameters and other clinical parameters were correlated with ALK and ROS1 mutation in NSCLC patients and may help to refine the process of optimal patient selection to gene test for targeted therapy.