Volume-Based Parameters of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Improve Outcome Prediction in Early-Stage Non-Small Cell Lung Cancer After Surgical Resection
Volume-Based Parameters of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Improve Outcome Prediction in Early-Stage Non-Small Cell Lung Cancer After Surgical Resection
复制标题
DOI：
10.1097/sla.0b013e318262a6ec
复制
发表时间：
2013-02-01
影响因子：
9
通讯作者：
Kim, Byung-Tae
中科院分区：
文献类型：
--
作者：
Hyun, Seung Hyup;Choi, Joon Young;Kim, Byung-Tae
目的：评价F-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描基于体积的参数的预后意义和预测性能（F-18-FDG PET/CT）在早期非小细胞肺癌（NSCLC）中的应用。虽然手术切除仍然是早期NSCLC的最佳治疗方法，大约40%的I期NSCLC患者和60%的II期NSCLC患者在根治性切除术后5年内复发并死亡。因此，需要确定额外的预后生物标志物，以制定风险适应性treatment strategies.Methods：我们回顾性分析了529例经病理证实的早期NSCLC患者，他们接受了术前F-18-FDG PET/CT检查。测量原发肿瘤的最大标准摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。采用Kaplan-Meier法评估总生存期（OS）和无病生存期（DFS）。通过考克斯比例风险回归分析评估PET参数和其他临床病理变量的预后意义。为了评估和比较PET参数的预测性能，使用时间依赖性受试者工作特征（ROC）曲线分析。在多元分析中，PET的基于体积的参数（MTV和TLG）作为连续变量分析与复发风险增加显著相关在校正年龄、性别、组织学、肿瘤分期和手术类型后，MTV组P = 0.001，TLG组P < 0.001）和死亡（MTV组P = 0.009，TLG组P = 0.007）。作为连续变量分析的SUVmax不是DFS（P = 0.056）和OS（P = 0.525）的显著预后因素。在ROC曲线分析中，PET容积参数的预测效果优于SUVmax（P < 0.001）。结论：PET容积参数是除肿瘤淋巴结转移分期外的一个独立的预后因素，对早期NSCLC患者的预后有较好的预测价值。
Objective: To evaluate the prognostic significance and predictive performance of volume-based parameters of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT) in early-stage non-small cell lung cancer (NSCLC).Background: Although surgical resection remains the optimal treatment for early-stage NSCLC, approximately 40% of patients with stage I and 60% of patients with stage II NSCLC relapse and die within 5 years after curative resection. Therefore, identification of additional prognostic biomarkers is needed to develop risk-adapted treatment strategies.Methods: We retrospectively reviewed 529 consecutive patients with pathologically proven early-stage NSCLC who underwent preoperative F-18-FDG PET/CT. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for the primary tumors were measured. Overall survival (OS) and disease-free survival (DFS) were assessed by the Kaplan-Meier method. The prognostic significance of PET parameters and other clinicopathological variables was assessed by Cox proportional hazards regression analysis. To evaluate and compare the predictive performance of PET parameters, time-dependent receiver operating characteristic (ROC) curve analysis was used.Results: In themultivariate analyses, volume-based parameters of PET (MTV and TLG) that were analyzed as continuous variables were significantly associated with an increased risk of recurrence (P = 0.001 for MTV, P < 0.001 for TLG) and death (P = 0.009 for MTV, P = 0.007 for TLG), after adjusting for age, sex, histology, tumor stage, and type of surgery. SUVmax analyzed as a continuous variable was not a significant prognostic factor for both DFS (P = 0.056) and OS (P = 0.525). In the time-dependent ROC curve analysis, the volume-based parameter of PET showed better predictive performance than SUVmax (P < 0.001).Conclusions: The volume-based parameter of PET is an independent prognostic factor for survival in addition to pathological tumor-node-metastasis stage and a promising tool for better prediction of outcome in patients with early-stage NSCLC.