摘要
目的探讨18F-FDG显像对评价晚期非小细胞肺癌(NSCLC)早期疗效及判断预后的价值。方法 32例晚期NSCLC患者分别在化疗前1周内及化疗后3周接受18F-FDG显像。对全部患者均随访1年,根据病灶影像学变化判断化疗疗效,并分为有效组和无效组,对比分析两组患者治疗前、后肿瘤与对侧正常组织放射性计数比值(T/N值)及其变化百分率(T/N变化百分率)与疗效和预后的关系,同时比较不同病理类型之间T/N值和T/N变化百分率的差异。通过ROC曲线找出判断疗效的最佳T/N变化百分率,以此数值为界将患者分为两组,绘制两组患者的1年累积生存曲线,Log-rank检验评估两组生存率的差异。结果有效组和无效组化疗前T/N值分别为7.41±3.91和6.97±2.49,差异无统计学意义(P>0.05)。有效组化疗3周后T/N值(5.43±2.86)低于无效组的8.51±4.61(t=2.18,P<0.05),有效组T/N变化百分率(-21.84±25.66)%低于无效组的(23.78±44.35)%(t=3.42,P<0.05)。鳞癌患者和腺癌患者在化疗前T/N值分别为8.35±2.56和6.35±3.30,化疗3周后分别为8.90±5.56和5.97±2.42,T/N变化百分率分别为(8.52±58.00)%和(0.61±30.20)%,差异均无统计学意义(P均≥0.05)。患者总体1年生存率为78.13%;有效组患者1年生存率为100%,高于无效组的61.11%(χ2=6.62,P<0.05)。ROC曲线分析得出评价疗效的最佳的T/N变化百分率为下降10%,其敏感度和特异度分别为88.9%和78.6%,ROC曲线下面积(AUC)为0.89,T/N变化百分率下降超过10%组的1年生存率为100%,高于不足10%组的63.27%(χ2=5.76,P<0.05)。结论化疗后的T/N变化百分率可作为评价晚期NSCLC疗效和判断预后的重要参考指标。
Objective To explore the value of 18F-FDG imaging in assessing the early efficacy of chemotherapy and prognosis of advanced non-small-cell lung cancer（NSCLC）.Methods Thirty-two patients with advanced NSCLC received 18F-FDG scan 1 week before and 3 weeks after chemotherapy.All patients were followed up for 1 year.The patients were divided into effective group and non-effective group according to the efficacy.The correlation of tumor to non-tumor（T/N） value and T/N declining percentage with curative effect was analyzed.The difference of T/N value and T/N declining percentage in the effect between pathological types was compared.According to ROC curve,the optional cutoff in the early prediction of therapeutic response was found.Log-rank tests were performed to assess the differences of survival rate.Results T/N value of effective group and non-effective group before therapy was 7.41±3.91 and 6.97±2.49,respectively（P0.05）.T/N value of effective group 3 weeks after chemotherapy（5.43±2.86） was lower than non-effective group（8.51±4.61,t=2.18,P0.05）.T/N value percentage change of effective group（[-21.84±25.66]%） was lower than non-effective group（[23.78±44.35]%,t=3.42,P0.05）.Before chemotherapy,T/N value of the squamous cell carcinoma and the adenocarcinoma was 8.35±2.56 and 6.35±3.30,while 3 weeks after chemotherapy was 8.90±5.56 and 5.97±2.42,respectively.T/N value percentage change of the two groups was（8.52±58.00）% and（0.61±30.20）%,respectively（all P≥0.05）.The overall 1 year survival rate was 78.13%,of the effective group was 100%,of non-effective group was 61.11%（χ2=6.62,P0.05）.Using ROC curve,the optional cutoff in early prediction of therapeutic response was declining percentage 10%,the sensitivity and specificity was 88.9% and 78.6%,respectively,the area under curve（AUC） was 0.89.The 1 year survival rate of patients with T/N value percentage change over or lower than 10% was 100% and 63.27%,respectively（χ2=5.76,P0.05）.Conclusion T/N value percentage change is an important parameter which can early predict therapeutic response and prognosis for advanced NSCLC.
出处
《中国医学影像技术》
CSCD
北大核心
2012年第5期929-933,共5页
Chinese Journal of Medical Imaging Technology
