18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma
18-Fluorodeoxyglucose Positron Emission Tomography Predicts Recurrence in Resected Pancreatic Ductal Adenocarcinoma
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DOI：
10.1007/s11605-017-3627-3
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发表时间：
2018-02-01
影响因子：
3.2
通讯作者：
Unno, Michiaki
中科院分区：
文献类型：
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作者：
Ariake, Kyohei;Motoi, Fuyuhiko;Unno, Michiaki
我们旨在确定是否应根据18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描对治疗进行分层在2006年至2014年期间接受术前18F-FDG PET/CT的患者（n = 138）被分层为高标准摄取值（SUVmax）。（a4.85）和低（< 4.85）PET组。回顾性分析其临床病理特征及预后，原发肿瘤SUVmax与术前CA 19 -9水平呈正相关（P < 0.001）。高PET组未能实现术后CA 19 -9正常化（P = 0.014）。高PET组的疾病特异性（P < 0.001）、无复发（P < 0.001）、无肝脏复发（P < 0.001）和无腹膜复发（P = 0.020）生存率显著较短。原发肿瘤SUVmax是肝转移的独立预测危险因素（风险比3.46，95%置信区间1.61-7.87; P = 0.001）和腹膜复发（危害比3.36，95%置信区间1.18-10.89; P = 0.023）。高PET组手术切除未能实现CA 19 -9正常化，且远处复发频繁。这表明即使在根治性切除后，远处部位也有可能残留癌。高PET组患者术前应加强全身化疗。
We aimed to determine whether treatment should be stratified according to 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake values (SUVmax) in pancreatic ductal adenocarcinoma.Patients who underwent preoperative 18F-FDG PET/CT between 2006 and 2014 (n = 138) were stratified into high (a 4.85) and low (< 4.85) PET groups. The clinicopathological characteristics and prognostic outcomes were analyzed retrospectively.The primary tumor SUVmax was positively correlated with preoperative CA19-9 levels (P < 0.001). The high PET group failed to achieve postoperative CA19-9 normalization (P = 0.014). Disease-specific (P < 0.001), recurrence-free (P < 0.001), liver recurrence-free (P < 0.001), and peritoneal recurrence-free (P = 0.020) survivals were significantly shorter in the high PET group. The primary tumor SUVmax was an independent predictive risk factor for liver metastasis (hazard ratio 3.46, 95% confidence interval 1.61-7.87; P = 0.001) and peritoneal recurrence (hazard ratio 3.36, 95% confidence interval 1.18-10.89; P = 0.023).Surgical resection failed to achieve CA19-9 normalization in the high PET group and distant recurrence was frequent. This suggests the potential for residual cancer at distant sites, even after curative resection. Stronger preoperative systemic chemotherapy is preferred for the high PET group patients.