Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning
Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning
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DOI：
10.1210/jc.2005-1534
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发表时间：
2006-02-01
影响因子：
5.8
通讯作者：
Larson, SM
中科院分区：
文献类型：
--
作者：
Robbins, RJ;Wan, Q;Larson, SM
背景/目的：大约15%的甲状腺癌患者随后发生转移。转移性甲状腺癌患者的临床过程是高度可变的。我们假设，转移性病灶的代谢活动，定义为保留2-[F-18]氟-2-脱氧葡萄糖（FDG），将与预后。设计/Patients：从400例甲状腺癌患者的初始FDG-正电子发射断层扫描（PET）扫描进行了回顾性分析，并与总生存率（中位随访，7.9年）进行比较。我们研究了预后价值的临床信息，如性别，年龄，血清甲状腺球蛋白，美国癌症联合委员会（AJCC）阶段，组织学，放射性碘亲和力，FDG-PET阳性，FDG-avid病变的数量，和糖酵解率最活跃的insulin.Results：年龄，初始阶段，组织学，甲状腺球蛋白，放射性碘摄取，PET结果都与生存的单变量分析。然而，在多变量分析中，只有年龄和PET结果仍然是生存率的强预测因素。通过多变量分析，美国癌症联合委员会的初始分期不是生存率的显著预测因素。生存和糖酵解率的最活跃的病变和FDG-avid lesions.Conclusions的数量之间有显着的反比关系：FDG-PET扫描是一种简单，昂贵，但强大的手段来重新分期甲状腺癌患者谁开发后续转移，分配给他们的组，无论是在低（FDG阴性）或高（FDG阳性）的癌症相关死亡率的风险。我们建议转移瘤治疗的积极性应与FDG-PET状态相匹配。
Context/Objective: Approximately 15% of thyroid cancer patients develop subsequent metastases. The clinical course of patients with metastatic thyroid carcinoma is highly variable. We hypothesized that the metabolic activity of metastatic lesions, as defined by retention of 2-[F-18]fluoro-2-deoxyglucose (FDG), would correlate with prognosis.Design/Patients: The initial FDG-positron emission tomography (PET) scans from 400 thyroid cancer patients were retrospectively reviewed and compared with overall survival (median follow-up, 7.9 yr). We examined the prognostic value of clinical information such as gender, age, serum thyroglobulin, American Joint Committee on Cancer (AJCC) stage, histology, radioiodine avidity, FDG-PET positivity, number of FDG-avid lesions, and the glycolytic rate of the most active lesion.Results: Age, initial stage, histology, thyroglobulin, radioiodine uptake, and PET outcomes all correlated with survival by univariate analysis. However, only age and PET results continued to be strong predictors of survival under multivariate analysis. The initial American Joint Committee on Cancer stage was not a significant predictor of survival by multivariate analysis. There were significant inverse relationships between survival and both the glycolytic rate of the most active lesion and the number of FDG-avid lesions.Conclusions: FDG-PET scanning is a simple, expensive, but powerful means to restage thyroid cancer patients who develop subsequent metastases, assigning them to groups that are either at low (FDG negative) or high ( FDG positive) risk of cancer-associated mortality. We propose that the aggressiveness of therapy for metastases should match the FDG-PET status.