Prognostic value of metabolic parameters measured by pretreatment dual-time-point 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with intrahepatic or perihilar cholangiocarcinoma: A STROBE study.
Prognostic value of metabolic parameters measured by pretreatment dual-time-point 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with intrahepatic or perihilar cholangiocarcinoma: A STROBE study.
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DOI：
10.1097/md.0000000000026015
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发表时间：
2021-05-28
期刊：
影响因子：
1.6
通讯作者：
Park JM
中科院分区：
文献类型：
--
作者：
Hwang JP;Moon JH;Kim HK;Lee MH;Lim CH;Park SB;Yoon JK;Park JM
本研究的目的是通过治疗前双时间点18 F-氟脱氧葡萄糖（18 F-FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）测定延迟相的葡萄糖代谢，为肝内或肝门周围胆管癌（ICC或PCC）患者提供独立于已知预后因素的预后信息。2012年7月至2017年12月，55例经病理证实的ICC或PCC患者（男性27例，女性28例，平均年龄68 ± 11岁）入组本回顾性研究。 在所有患者中进行双时间点18F-FDG PET/CT作为分期检查的一部分。患者的数据包括年龄、性别、血清CA 19 -9、是否存在LN或远处转移、早期SUVmax（早期最大标准化摄取值[eSUV]）、延迟SUVmax（延迟最大标准化摄取值[dSUV]）、SUVmax保留指数（最大标准化摄取值变化百分比[ΔSUV]）、中性粒细胞与淋巴细胞比率（NLR）和组织病理学（包括pCEA、p53、Ki-67指数）。采用Kaplan-Meier曲线和考克斯比例风险回归模型分析代谢指标与生存率的关系。所有患者的中位生存期为357天。中位早期和延迟SUVmax分别为5.2（范围：2.0-21.4）和6.5（范围：2.7-24.5）。单因素分析发现eSUV、dSUV、ΔSUV、年龄、血清CA 19 -9和NLR与总生存期显著相关。在多变量分析中，dSUV（P = 0.014，95%CI; 1.30-10.7，HR 3.74）和ΔSUVmax（P = 0.037，95%CI; 1.05-6.12，HR 2.5）是总生存期的独立因素。 Kaplan-Meier曲线分析明确显示，在FDG PET上SUV参数的比较中，2组之间的总生存率存在显著差异（高eSUV、低eSUV +高ΔSUV vs低eSUV和ΔSUV，P <0.001）。 在使用SUV参数组合的受试者工作特征分析中，2组[eSUV + ΔSUV（P =.0001，曲线下面积[AUC] 0.68）和dSUV + ΔSUV（P =.0002，AUC 0.71）]显示AUC显著大于单独使用eSUV或dSUV的其他组（AUC 0.61和AUC 0.68）。 治疗前双时间点18F-FDG PET/CT的dSUV和ΔSUV可作为预测ICC或PCC患者生存的有用参数。
The purpose of this study was to determine the glucose metabolism at delay phase measured by pretreatment dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/ computed tomography (CT) provides prognostic information independent of well-known prognostic factors in patients with intrahepatic or perihilar cholangiocarcinoma (ICC or PCC). From July 2012 to December 2017, 55 patients (men 27, women 28, mean age 68 ± 11 years) with pathologically proven ICC or PCC were enrolled in this retrospective study. The dual-time-point 18F-FDG PET/CT as part of a staging workup was performed in all patients. The patient's data includes age, sex, serum CA19-9, presence of LN or distant metastasis, early SUVmax (early maximum standardized uptake value [eSUV]), delay SUVmax (delay maximum standardized uptake value [dSUV]), retention index of SUVmax (percent change of maximum standardized uptake values [ΔSUV]), neutrophil to lymphocyte ratio (NLR) and histopathology including pCEA, p53, Ki-67 index. The analysis of the relationship between metabolic parameters and survival was done using the Kaplan–Meier curve and Cox proportional hazards regression model. Median survival for all patients was 357 days. Median early and delay SUVmax was 5.2 (range: 2.0–21.4) and 6.5 (range 2.7–24.5), respectively. The overall survival was found to be significantly related to eSUV, dSUV, ΔSUV, age, serum CA19-9 and NLR in univariate analysis. In multivariate analysis, dSUV (P = .014, 95%CI; 1.30–10.7, HR 3.74) and ΔSUVmax (P = .037, 95%CI; 1.05–6.12, HR 2.5) were independent factors of overall survival. Kaplan–Meier curve analysis clearly showed the significant difference of overall survival between 2 groups (high eSUV, low eSUV + high ΔSUV vs low eSUV and ΔSUV, P < .001) among the comparisons of the SUV parameters on FDG PET. In the receiver operating characteristic analysis using combinations of the SUV parameters, the 2 groups [eSUV + ΔSUV (P = .0001, area under the curve [AUC] 0.68) and dSUV + ΔSUV (P = .0002, AUC 0.71)] showed significantly larger AUC than the other groups applying eSUV or dSUV alone (AUC 0.61 and AUC 0.68). dSUV and ΔSUV on pretreatment dual-time-point 18F-FDG PET/CT can be useful parameters in the prediction of survival in patients with ICC or PCC.