High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma
High FDG uptake in PET/CT predicts worse prognosis in patients with metastatic gastric adenocarcinoma
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DOI：
10.1007/s00432-010-0852-5
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发表时间：
2010-12-01
影响因子：
3.6
通讯作者：
Lee, Kyung-Yung
中科院分区：
文献类型：
--
作者：
Chung, Hyun Woo;Lee, Eun Jeong;Lee, Kyung-Yung
我们评估了FDG-PET/CT在转移性胃腺癌患者姑息性化疗前预测预后和化疗反应的作用。该研究纳入了连续35例新诊断的转移性胃腺癌患者，这些患者在姑息性化疗前接受了FDG-PET/CT检查。评估原发肿瘤的最大标准化摄取值（SUVmax）以评估生存和化疗反应。采用Kaplan-Meier法对进展时间和总生存期进行生存分析。采用Cox比例风险模型确定独立预后因素。所有原发肿瘤均采用FDG-PET/CT显像（平均SUVmax = 8.1 +/- A 4.5，范围2.5-22.1）。FDG-PET/CT检测实体器官转移的敏感性为95.2%(20/21)，特异性为100%(14/14)，准确性为97.1%（34/35）。原发肿瘤SUVmax在化疗反应组间差异无统计学意义。单因素生存分析显示ECOG表现状态（千分之一2）、实体器官转移的存在、远处转移的器官数量（千分之一2）和原发肿瘤的SUVmax （bbb8）是总体生存差的重要预测因素。多因素生存分析显示，原发肿瘤的SUVmax （P = 0.048）、实体器官转移的存在（P = 0.015）和ECOG表现状态（P = 0.002）是总生存的重要独立预后指标。转移性胃腺癌患者原发肿瘤的高FDG摄取与较差的总生存率相关。评估肿瘤FDG摄取对预测化疗反应的价值有限，但提供了有关预后的有用信息。
We evaluated the role of FDG-PET/CT in patients with metastatic gastric adenocarcinoma before palliative chemotherapy to predict prognosis and chemotherapeutic response.The study included 35 consecutive newly diagnosed patients with metastatic gastric adenocarcinoma who underwent FDG-PET/CT before palliative chemotherapy. Maximum standardized uptake value (SUVmax) of the primary tumor was assessed to evaluate survival and chemotherapeutic response. Survival analysis was performed for time to progression and overall survival using the Kaplan-Meier method. Cox proportional hazard models were used to determine independent prognostic factors.All primary tumors were visualized using FDG-PET/CT (mean SUVmax = 8.1 +/- A 4.5, range 2.5-22.1). Sensitivity, specificity, and accuracy of FDG-PET/CT in detection of solid organ metastasis were 95.2% (20/21), 100% (14/14), and 97.1% (34/35), respectively. No significant difference of primary tumor SUVmax was found among the chemotherapeutic response groups. Univariate survival analysis demonstrated ECOG performance status (a parts per thousand yen2), presence of solid organ metastasis, number of organs involved in distant metastasis (a parts per thousand yen2), and SUVmax of the primary tumor (> 8) as significant predictors for poor overall survival. Multivariate survival analysis showed SUVmax of the primary tumor (P = 0.048), presence of solid organ metastasis (P = 0.015), and ECOG performance status (P = 0.002) as significant independent prognostic predictors for overall survival.High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.