NM23表达对18F-FDG PET/CT在非小细胞肺癌患者放疗计划中的影响

目的  分析NM23基因表达情况对非小细胞肺癌的生物学行为及对放疗计划的影响。方法  以新疆医科大学附属肿瘤医院107例非小细胞肺癌患者为研究对象，在PET/CT影像下制定放疗方案，勾画一般靶区体积，危及器官受照量，按免疫组化结果分为NM23高表达组(n=43)和低表达组(n=64)，比较两组间PET/CT代谢参数最大标准化摄取值、PET/CT图像下勾画的放疗大体靶区体积、危及器官受照量的差异。结果  NM23高表达组与低表达组在PET/CT中代谢参数测量的最大标准化摄取值测量方面，高表达组最大标准化摄取值小于低表达组，差异有统计学意义（P < 0.05）；在NM23低表达组与NM23高表达组制定的放疗计划中，两组在大体靶区体积、危及器官的受照体积方面，NM23高表达组小于低表达组，差异有统计学意义（P < 0.05）。结论  深入了解非小细胞肺癌患者NM23基因表达情况及其生物学行为，将PET/CT运用于放疗计划的制定中，能够为非小细胞肺癌患者放疗靶区的精准雕刻提供更多的参考信息。

Effect of NM23 expression on 18F-FDG PET/CT in non-small cell lung cancer radiotherapy schedule

Objective To analyze the influence of NM23 gene expression status on the biological behavior of non-small cell lung cancer and on radiotherapy planning. Methods A total of 107 patients with non-small cell lung cancer in the Cancer Hospital of Xinjiang Medical University were taken as the study subjects, and the radiotherapy protocols were formulated under PET/CT images, the general target area volume outlined under PET/CT images, and the amount of critical organs irradiated, which were divided into high NM23 expression group(n=43) and low NM23 expression group(n=64) according to the results of immunohistochemistry, and the differences in the maximal standardized uptake value of metabolic parameters of PET/CT, the PET/CT images, the volume of the radiotherapy macroscopic target area outlined under the images, and the differences in the amount of critical organs irradiated were compared. Results The maximum standardized uptake value of metabolic parameters measured in PET/CT in the NM23 high-expression group was smaller than that of the low-expression group, and the difference was statistically significant (P < 0.05). In the radiotherapy plans formulated by the NM23 low-expression group and the NM23 high- expression group, the volume of the macroscopic target area, and the volume of the organs at risk of radiation were smaller than that of the low-expression group in the NM23 high-expression group, and the differences were statistically significant (P < 0.05). Conclusion In-depth understanding of NM23 gene expression and its biological behavior in NSCLC patients, and the use of PET/CT in the development of radiotherapy plans can provide more reference information for the precise sculpting of radiotherapy targets in non-small cell lung cancer patients.