Metabolic tumor burden on postsurgical PET/CT predicts survival of patients with gastric cancer
Metabolic tumor burden on postsurgical PET/CT predicts survival of patients with gastric cancer
复制标题
术后 PET/CT 的代谢肿瘤负荷可预测胃癌患者的生存
DOI：
10.1186/s40644-019-0205-9
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发表时间：
2019-03-22
期刊：
影响因子：
4.9
通讯作者：
Li, Danni
中科院分区：
文献类型：
--
作者：
Sun, Gaofeng;Cheng, Chao;Li, Danni
术后18F-脱氧葡萄糖(18F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)对胃癌患者的预后价值尚不清楚。本研究旨在探讨18F-FDG PET/CT全身代谢肿瘤负荷(MTBWB)对胃癌患者手术后18F-FDG PET/CT的预后价值。收集临床病理资料、总生存率(OS)和术后PET/CT的MTBWB参数，包括WB最大标准摄取值(SUVWBmax)、WB代谢性肿瘤体积(MTVWB)和WB总病变糖酵解(TLGWB)。采用卡方检验、Fisher精确检验、t检验或Kaplan-Meier生存分析比较患者临床病理特征、OS和MTBWB值的差异。通过对受试者工作特性(ROC)曲线的分析，计算出MTBWB测量的最佳截止值。结果经Kaplan-Meier生存分析(P<； ，0.001)或单因素COX回归分析(Risk Ratio[HR] = 2.850，P<； (0.001))，PET阳性患者的OS显著降低。在PET阳性的肿瘤患者中，OS与SUVWBmax、MTVWB和TLGWB的相关性在单变量分析(P<； 分别为0.001，P<； ：0.001和P= 0.001)和多变量分析(P= 0.002，P<； ：0.001和P= 0.005)中均显著相关。以SUVWBmax>； 8.6、MTVWB>； 91.5 cm3、TLGWB>； 477.6 cm3为界值分组间的患者OS差异有统计学意义(P= 0.001，P<； =0.001，P= 0.001)。结论18F-FDGPET/CT对胃癌根治术后患者的MTBBmax、MTVWB和TLGWB有较高的预测价值。
BackgroundThe prognostic value of postoperative18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to patients with gastric cancer remains unclear. This study aims to investigate the prognostic value of whole body (WB) metabolic tumor burden (MTBWB) on postsurgical18F-FDG PET/CT to patients with gastric cancer.MethodsA total of 376 patients with surgeries-confirmed gastric cancer were enrolled. Clinicopathologic information, overall survival (OS) and MTBWBparameters on postsurgical PET/CT, in terms of WB maximum standardized uptake value (SUVWBmax), WB metabolic tumor volume (MTVWB), and WB total lesion glycolysis (TLGWB) were collected. In-between differences of patient clinicopathologic characteristics, OS and MTBWBmeasurements were compared using chi-square test, Fisher’s exact test, Student’s t test or the Kaplan-Meier survival analysis. The optimal cutoffs of MTBWBmeasurements were calculated through the receiver operating characteristic (ROC) curve analysis. Univariable and multivariable Cox proportional hazard regression were performed to test the predictive value of the clinicopathologic factors and MTBWBmeasurements to patient survival.ResultsThe PET-positive patients had significantly decreased OS based on either Kaplan-Meier survival analysis (P< 0.001) or univariable Cox regression (hazard ratio [HR] = 2.850,P< 0.001). In patients with PET-positive tumors, the associations between OS and SUVWBmax, MTVWBand TLGWBwere significant, both in univariable analysis (P< 0.001,P< 0.001 andP= 0.001, respectively) and in multivariable analysis (P= 0.002,P< 0.001 andP= 0.005, respectively). Patient OS among groups dichotomized by cutoffs of SUVWBmax> 8.6, MTVWB> 91.5 cm3, and TLGWB> 477.6 cm3were significantly different (P= 0.001,P< 0.001 andP= 0.001, respectively).ConclusionsMTBWB, in terms of SUVWBmax, MTVWBand TLGWB, on postsurgical18F-FDG PET/CT provides prognostic value to patients with gastric cancer after curative resection.