非小细胞肺癌18F—FDGPET／CT标准摄取值影响因素及临床应用

目的：探讨非小细胞肺癌（non-sinail cell lungcancer，NSCLC）在PET／CT显像中18F-FDG标准化摄取值（standard uptake value，SUV）的影响因素及临床应用。方法：应用PubMed及CNKI期刊全文数据库检索系统，以“非小细胞肺癌、18F-FDG摄取值、影响因素和预后”等为关键词，检索2004—2014年的相关文献。共检索到英文文献4032条，中文文献622条。纳入标准：1）影响NSCLC中SUV的相关因素；2）SUV对于NSCLC治疗效果的评价；3）SUV对于NSCLC预后的预测。根据纳入标准，符合分析文献32篇。结果：NSCLCSUV与肿瘤大小和细胞增殖程度呈正相关；与肿瘤细胞分化程度呈负相关；与肿瘤病理类型存在相关性，腺癌的SUV低于鳞癌；与EGFR基因突变存在相关性，低SUV者更易发生EGFR基因突变；与免疫组化和ALK基因重排可能存在部分相关性。SUV可能有助于早期预测NSCLC放化疗或靶向治疗的疗效。SUV是NSCLC患者的独立预后因素。结论：NSCLC18F-FDG摄取值受到许多临床因素的影响，并对于临床治疗反应的评估、预后判断以及临床决策产生重要影响。

Influence factors and clinical application of 18F-FDG PET/CT uptake value in non-small cell lung cancer

OBJECTIVE：To summarize the influential factors of 18 F-FDG standard uptake value（SUV） in non-small cell lung cancer（NSCLC） scanning by PET/CT,and how SUV helps to evaluate the treatment results,forecast the clinical prognosis and determine the therapeutic regimen. METHODS：The fulltext database retrieval system of PubMed and CNKI were searched. The words NSCLC,FDG standard uptake value,influence factor, prognosis were used as key words to retrieve the literature from 2004 to 2014. Totally 4 032 pieces of English literature and 622 pieces of Chinese were retrieved respectively. Inclusion criteria：1） influence factors of SUV in NSCLC;2） SUV evaluates the treatment result in NSCLC; 3） SUV forecasts the prognosis of NSCLC. Finally 32 papers were selected and analyzed. RESULTS： In NSCLC,SUV is positively correlated with tumor size and extent of proliferations differentiation of tumor cells shows a negative correlation; pathological type is correlated with SUV,adenocarcinoma has a lower level than squamous cell; EGFR mutations are correlated,lower SUV indicates EGFR mutation more likely than the wild type;Both Immunohistochemistry and ALK gene rearrangement are also some correlated with SUV. SUV may forecast the results of radiochemotherapy and target therapy at early stage. SUV is an independent prognostic factor of NSCLC patients. CONCLUSION：SUV is influenced by many clinical factors in NSCLC,and plays an important rote in the clinical evaluation, prognosis and decision.