非小细胞肺癌FDG摄取与转移的关系

目的 观察治疗前非小细胞肺癌患者的原发灶18F-脱氧葡萄糖(FDG)摄取与淋巴结和(或)远处转移的关系.方法 回顾性分析山东省肿瘤医院2004年6月至2007年4月治疗前行FDGPET/CT检查的拟诊肺癌患者资料,共收集到病理或细胞学检查明确诊断(除外糖尿病者)的肺腺癌患者94例和鳞癌65例资料.先分析原发灶大小(以CT肺窗的最大径表示)与FDG摄取以最大标准摄取值(SUVmax)表示]关系,然后分析腺癌、鳞癌不同转移状态组间分为无转移组和有淋巴结和(或)远处转移组]原发灶FDG摄取值的差异,并进一步采用Logistic回归法分析影响转移的因素.结果 原发灶的大小与FDG摄取呈正相关(腺癌:r=0.610,P<0.01;鳞癌:r=0.587,P<0.01),整体分析表明非小细胞肺癌原发灶FDG摄取值是影响淋巴结和(或)远处转移的因素优势比(0R)=1.172,P=0.010],而原发灶大小不是影响因素(OR=0.906,P=0.513);分层分析发现肺鳞癌不同转移状态组间的FDG摄取差异无统计学意义(有、无转移组SUVmax分别为11.45±6.04和10.94±4.20,χ2=0.013,P=0.911),而肺腺癌有转移组的FDG;摄取值显著高于无转移组(SUVmax分别为10.28±3.92和6.33±2.89,χ2=15.125,P<0.01),Logistic分析表明肺腺癌原发灶的FDG;摄取值是影响转移的有意义因素(OR=1.403,P=0.002).结论 肺腺癌原发灶FDG摄取与转移有关,高FDG摄取提示可能已经发生转移;而肺鳞癌FDG摄取与转移无关.

Relationship between fluorodeoxyglucose uptake of primary tumor and metastases in non-small cell lung cancer patients

Objective 18F-fluorodeoxyglnoose (FDG) uptake value of PET has been linked to tumor aggressiveness and prognosis. The aim of this study was to investigate whether the degree of FDG up-take could be correlated with the presence of nodal or distant metastases in untreated lung adenocarcinoma (AC) or squamous cell carcinoma (SCC) patients. Methods 18F-FDG PET/CT scan and histopathologi-cal findings of lung cancer patients in our hospital between June, 2004 to April, 2007 were respectively re-viewed. Only untreated patients confirmed by histology or cytology were enrolled, which included 94 AC and 65 SCC patients. Tumor size was quantified with the greatest dimension and degree of FDG uptake with the maximum standardized uptake value (SUVmax). The associations between SUVmax and tumor size were case-tu-case analyzed. The degree of FDG uptake was compared with metastatic status (absence or presence any nodal or distant metastasis) in all patients and between AC and SCC groups. Logistic regression was used to determine the factors affecting the presence or absence of nodal and (or) distant metastases. Results A positive correlation was found between the SUVmax and size for either AC or SCC (r=0.610 vs r=0.587,both P<0.01). Degree of tumor FDG uptake ods ratio (OR)=1.172, P=0.010], but not size(OR=0.906, P=0.513), was related to the metastatic status in non-small cell lung cancer patients. Significant difference was found between different metastatic status for AC patients in SUVmax(metastatic:10.28±3.92, non-metastatic: 6.33±2.89;χ2=15.125, P<0.01), but not for SCC patients(metastatic: 11.45±6.04, non-metastatic: 10.94±4.20; χ2=0.013, P=0.911). Logistic regression analysis demonstrated that SUVmax of primary tumor was a significant factor in predicting the presence of nodal or distant metastases forAC patients(OR=1.403,P=0.002), but not for SCC(OR=1.034, P=0.608). Conclusion The degree of primary tumor FDG uptake is a predictive factor for the presence or absence of nodal or distant me-tastases for AC, but not for SCC, in non-small cell lung cancer patients.