非小细胞肺癌患者葡萄糖代谢显像半定量指标与肿瘤增殖指数相关性

Abstract

[目的]评价最大标准化摄取值(SUVmax)与Ki-67相关性,以期对接受氟[~(18)F]-氟代脱氧葡萄糖(~(18)F-fluorodeoxyglucose)正电子发射断层显像/计算机体层摄影(~(18)F-FDG PET/CT)检查的非小细胞肺癌(NSCLC)患者的肿瘤增殖活性预估判断。[方法]回顾性分析我院经手术病理证实的111例初发NSCLC的临床病理资料和~(18)F-FDG PET/CT显像结果。采用多因素线性回归和亚组分析对原发灶SUVmax和Ki-67进行相关分析。以不同的界值将SUVmax转变为二分类变量,分别与Ki-67以及其他临床参数进行用多因素Logistic回归,寻找SUVmax与Ki-67相关的最佳界值。[结果]多因素线性回归显示病理亚型、TNM分期、原发灶最大径,Ki-67与SUVmax中度相关(r=0.66)。亚组相关分析提示:当原发灶为腺泡为主型时、以及不论有无淋巴结转移,SUVmax均与Ki-67相关。多因素Logistic回归显示分类变量SUVmax(界值2.5)与Ki-67相关(P=0.01)。[结论] NSCLC的原发病灶葡萄糖代谢显像半定量参数SUVmax与肿瘤增殖活性指标Ki-67中度相关,SUVmax≥2.5提示肿瘤增殖活跃,初步判断患者预后不良。

[Objective] To investigate the association between the preoperative maximum standardized uptake value(SUVmax) of primary lesions measured on~(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(~(18)F-FDG PET/CT) and expression of Ki-67 labeling index(Ki-67) in patients with non-small cell lung cancer(NSCLC). [Methods] One hundred and eleven patients with NSCLC received surgical treatment and the~(18)F-FDG PET/CT examination was performed preoperatively. The SUVmax values of~(18)F-FDG PET/CT were estimated,and the expression of Ki-67 in cancer tissue was detected with histoimmunochemistry SP method. The association between SUVmax and Ki-67 expression,and the association of dichotomized SUVmax(2.5),mean SUVmax and median SUVmax with Ki-67 was analyzed with multivariate Logistic regression,respectively. [Results] Multiple linear regression showed regardless of pathological subtypes,TNM stage and maximum diameter of primary lesion,Ki-67 and SUVmax displayed a moderate correlation(r=0.66). In acinar predominant adenocarcinoma,N0 or N1-3,SUVmax was significantly correlated with Ki-67. Dichotomous SUVmax(cutoff point:2.5) was significantly associated with Ki-67(P=0.01). [Conclusion] A moderate relationship exists between the SUVmax values and Ki-67 expression. SUVmax ≥2.5 of primary lesion may suggest active tumor proliferation and poor prognosis of patients with NSCLC.