Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis.
Prognostic Value of 18F-FDG PET/CT in Surgical Non-Small Cell Lung Cancer: A Meta-Analysis.
复制标题
18F-FDG PET/CT 在手术非小细胞肺癌中的预后价值：荟萃分析。
DOI：
10.1371/journal.pone.0146195
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Yu J
中科院分区：
文献类型：
--
作者：
Liu J;Dong M;Sun X;Li W;Xing L;Yu J
手术治疗的非小细胞肺癌（NSCLC）患者预后差，由于其5年死亡率高，因此其识别是临床肿瘤学的优先事项。该荟萃分析探讨了最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）对手术NSCLC患者无病生存期（DFS）和总生存期（OS）的预后价值。对MEDLINE、EMBASE和科克伦图书馆进行了系统性检索，直至2015年8月1日。纳入了前瞻性或回顾性研究，这些研究评价了术前18F-FDG PET/CT在手术NSCLC患者中的预后作用，并提供了完整的DFS和OS数据。使用风险比（HR）测量SUVmax、MTV或TLG对生存率的影响。根据疾病分期、病理分类、仅手术和临界值进行亚组分析。纳入了36项研究，包括5807例患者。DFS的合并HR为2.74（95%CI 2.33-3.24，未调整）和2.43（95%可信区间：1.76-3.36，调整后），SUV最大，2.27 MTV为2.49（95%CI 1.77-2.90，未校正）和2.49（95%CI 1.23-5.04，校正），TLG为2.46（95%CI 1.91-3.17，未校正）和2.97（95%CI 1.68-5.28，校正）。OS的合并HR为2.54（95%CI 1.86-3.49，未校正）和1.52（95%CI 1.16-2.00，调整后）SUV最大值为2.07 MTV为2.47（95%CI 1.38-4.43，未校正）和1.94（95%CI 1.12-3.33，校正）。Begg检验检测到发表偏倚，进行修剪和填充程序，获得相似的HR。SUVmax、MTV和TLG的预后作用在亚组分析中保持相似。SUVmax、MTV和TLG的高值预测手术NSCLC患者的复发或死亡风险较高。我们建议使用FDG PET/CT来选择疾病复发或死亡风险高的患者，并可能从积极的治疗中获益。
The identification of surgical non-small cell lung cancer (NSCLC) patients with poor prognosis is a priority in clinical oncology because of their high 5-year mortality. This meta-analysis explored the prognostic value of maximal standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on disease-free survival (DFS) and overall survival (OS) in surgical NSCLC patients. MEDLINE, EMBASE and Cochrane Libraries were systematically searched until August 1, 2015. Prospective or retrospective studies that evaluated the prognostic roles of preoperative 18F-FDG PET/CT with complete DFS and OS data in surgical NSCLC patients were included. The impact of SUVmax, MTV or TLG on survival was measured using hazard ratios (HR). Sub-group analyses were performed based on disease stage, pathological classification, surgery only and cut-off values. Thirty-six studies comprised of 5807 patients were included. The combined HRs for DFS were 2.74 (95%CI 2.33–3.24, unadjusted) and 2.43 (95%CI: 1.76–3.36, adjusted) for SUVmax, 2.27 (95%CI 1.77–2.90, unadjusted) and 2.49 (95%CI 1.23–5.04, adjusted) for MTV, and 2.46 (95%CI 1.91–3.17, unadjusted) and 2.97 (95%CI 1.68–5.28, adjusted) for TLG. The pooled HRs for OS were 2.54 (95%CI 1.86–3.49, unadjusted) and 1.52 (95%CI 1.16–2.00, adjusted) for SUVmax, 2.07 (95%CI 1.16–3.69, unadjusted) and 1.91 (95%CI 1.13–3.22, adjusted) for MTV, and 2.47 (95%CI 1.38–4.43, unadjusted) and 1.94 (95%CI 1.12–3.33, adjusted) for TLG. Begg’s test detected publication bias, the trim and fill procedure was performed, and similar HRs were obtained. The prognostic role of SUVmax, MTV and TLG remained similar in the sub-group analyses. High values of SUVmax, MTV and TLG predicted a higher risk of recurrence or death in patients with surgical NSCLC. We suggest the use of FDG PET/CT to select patients who are at high risk of disease recurrence or death and may benefit from aggressive treatments.