Predictions of Pathological Features and Recurrence Based on FDG-PET Findings of Esophageal Squamous Cell Carcinoma after Trimodal Therapy
Predictions of Pathological Features and Recurrence Based on FDG-PET Findings of Esophageal Squamous Cell Carcinoma after Trimodal Therapy
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DOI：
10.1245/s10434-020-08609-0
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发表时间：
2020-05-13
影响因子：
3.7
通讯作者：
Okada, Morihito
中科院分区：
文献类型：
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作者：
Hamai, Yoichi;Emi, Manabu;Okada, Morihito
背景 肿瘤细胞的代谢活性程度可以通过 18F-氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）来确定。三模式治疗下局部晚期食管鳞状细胞癌（ESCC）原发肿瘤摄取 FDG 与此类肿瘤病理特征之间的关联尚未得到充分研究。患者和方法 我们评估了 143 名接受新辅助放化疗 (NCRT) 并随后进行手术的 ESCC 患者术前 PET 图像中原发肿瘤的最大标准化摄取 (SUVmax) 与病理特征以及癌症复发之间的关系。结果 NCRT 后 SUVmax 的 ypT 和 ypN 状态、淋巴侵犯 (LI)、静脉侵犯 (VI) 和复发方面存在显着差异。此外，LI、VI 和复发的 %Delta SUVmax（NCRT 前后的下降率）存在显着差异。单变量和多变量分析选择 post-SUVmax 和 %Delta SUVmax 作为无复发生存的独立术前预测因子[风险比 (HR) 1.46； 95% 置信区间 (CI) 1.24-1.72，HR 0.97； 95% CI 分别为 0.96-0.99；两者均 p < 0.001]。根据预测复发的最佳 SUVmax 截止值（术后 SUVmax 和 %Delta SUVmax：分别为 2.8 和 70），对无复发生存率和总生存率进行显着分层。结论 三模式治疗下原发肿瘤的术后 SUVmax 和 %Delta SUVmax 与 ESCC 的病理特征和复发显着相关。因此，FDG-PET可以术前预测三模式治疗下食管鳞癌的侵袭性肿瘤行为程度。
Background The degree of metabolic activity in tumor cells can be determined by 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET). Associations between FDG uptake by primary tumors of locally advanced esophageal squamous cell carcinoma (ESCC) under trimodal therapy and the pathological features of such tumors have not been fully investigated. Patients and Methods We evaluated relationships between the maximal standardized uptake (SUVmax) in primary tumors on preoperative PET images and pathological features as well as cancer recurrence in 143 patients with ESCC who underwent neoadjuvant chemoradiotherapy (NCRT) followed by surgery. Results The post-SUVmax significantly differed after NCRT for ypT and ypN status, lymphatic invasion (LI), venous invasion (VI), and recurrence. Furthermore, the %Delta SUVmax (rate of decrease between before and after NCRT) for LI, VI, and recurrence significantly differed. Univariate and multivariate analyses selected post-SUVmax and %Delta SUVmax as independent preoperative predictors of recurrence-free survival [hazard ratio (HR) 1.46; 95% confidence interval (CI) 1.24-1.72 and HR 0.97; 95% CI 0.96-0.99, respectively; p < 0.001 for both]. Recurrence-free and overall survival were significantly stratified according to optimal SUVmax cutoffs for predicting recurrence (post- and %Delta SUVmax: 2.8 and 70, respectively). Conclusions The post- and %Delta SUVmax of primary tumors were significantly associated with the pathological features and recurrence of ESCC under trimodal therapy. Therefore, FDG-PET can preoperatively predict the degree of aggressive tumor behavior in ESCC under trimodal therapy.