Correlations of 18F-FDG and 18F-FLT uptake on PET with Ki-67 expression in patients with lung cancer: a meta-analysis
Correlations of 18F-FDG and 18F-FLT uptake on PET with Ki-67 expression in patients with lung cancer: a meta-analysis
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DOI：
10.1177/0284185117706609
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发表时间：
2018-02-01
期刊：
影响因子：
1.3
通讯作者：
Kuang, Anren
中科院分区：
文献类型：
--
作者：
Shen, Guohua;Ma, Huan;Kuang, Anren
背景资料：正电子发射断层扫描（PET）显像使用放射性示踪剂18 F-氟脱氧葡萄糖（FDG）或18 F-氟胸苷（FLT）已被提出作为细胞增殖的影像学生物标志物。目的：探讨肺癌患者的FDG和FLT摄取与Ki-67标记指数的相关性。材料和方法：主要数据库进行了系统检索，所有相关文献发表在英文。使用随机效应模型对单个研究的相关系数（rho）及其95%置信区间（CI）进行荟萃分析。异质性的来源进行了探讨，通过亚组analysis.Results：27篇文章，涉及1213例患者被纳入本荟萃分析，包括22项研究FDG摄取/Ki-67表达相关性和8 FLT摄取/Ki-67表达相关性。18F-FDG/Ki-67相关性和18F-FLT/Ki-67相关性的合并rho值分别为0.45（95%CI，0.41-0.50）和0.65（95%CI，0.56-0.73），表明前者中度相关，后者显著相关。尽管基于研究设计、扫描仪、样本方法和Ki-67标记方法的亚组分析不能显著解释异质性，但这些因素是异质性的潜在来源。肺癌组FDG摄取的合并SUVmax显著高于FLT摄取的合并SUVmax（7.59比3.86，P < 0.05）。结论：18F-FDG和18F-FLT均与肺癌组织中Ki-67标记指数相关，而18F-FLT与Ki-67标记指数的相关性更强，可能是评价肺癌细胞增殖的可靠指标。
Background: Positron emission tomography (PET) imaging using the radiotracers 18F-fluorodeoxyglucose (FDG) or 18F-fluorothymidine (FLT) has been proposed as imaging biomarkers of cell proliferation.Purpose: To explore the correlations of FDG and FLT uptake with the Ki-67 labeling index in patients with lung cancer.Material and Methods: Major databases were systematically searched for all relevant literature published in English. The correlation coefficient (rho) and its 95% confidence interval (CI) of individual studies were meta-analyzed using a random-effects model. The sources of heterogeneity were explored by subgroup analyses.Results: Twenty-seven articles involving 1213 patients were included in this meta-analysis, comprising 22 studies for FDG uptake/Ki-67 expression correlation and eight for FLT uptake/Ki-67 expression correlation. The pooled rho values for 18F-FDG/Ki-67 correlation and 18F-FLT/Ki-67 correlation were 0.45 (95% CI, 0.41-0.50) and 0.65 (95% CI, 0.56-0.73), respectively, which indicated a moderate correlation for the former and a significant one for the latter. Although the subgroup analyses based on study design, scanner, sample method, and Ki-67 labeling method did not significantly explain the heterogeneity, these factors were potential sources of heterogeneity. In lung cancer, the pooled SUVmax of FDG uptake was significantly higher than that of FLT uptake (7.59 versus 3.86, P < 0.05). In addition, compared to FDG, FLT showed higher specificity yet lower sensitivity for the diagnosis of pulmonary lesions.Conclusion: Both 18F-FDG and 18F-FLT correlate significantly with the Ki-67 labeling index in pulmonary lesions, and the latter, with a stronger correlation, may be more reliable for assessing tumor cell proliferation in lung cancer.