| 刘丽,王火强,李梅,刘进军,赵龙.18F-FDG显像评价晚期非小细胞肺癌化疗疗效及预后[J].中国医学影像技术,2012,28(5):929~933 |
| 18F-FDG显像评价晚期非小细胞肺癌化疗疗效及预后 |
| Evaluation on efficacy of chemotherapy and prognosis of advanced non-small cell lung cancer with 18F-FDG imaging |
| 投稿时间：2011-09-23 修订日期：2012-10-20 |
| DOI： |
| 中文关键词: 癌,非小细胞肺 18F 氟脱氧葡萄糖 放射性核素显像 治疗 预后 |
| 英文关键词:Carcinoma, non-small-cell lung Fluorodeoxyglucose F18 Radionuclide imaging Therapy Prognosis |
| 基金项目: |
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| 摘要点击次数: 2557 |
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| 中文摘要: |
| 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。 |
| 英文摘要: |
| 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 (P>0.05). 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, P<0.05). T/N value percentage change of effective group ( %) was lower than non-effective group ( %, t=3.42, P<0.05). 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, P<0.05). 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, P<0.05). Conclusion T/N value percentage change is an important parameter which can early predict therapeutic response and prognosis for advanced NSCLC. |
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