张利卜, 徐文贵, 汪莹, 戴东, 马文超, 朱研佳, 门晓媛. PET/CT纵隔淋巴结SUVmax与N0~N 1期非小细胞肺癌手术患者预后相关性的研究[J]. 中国肿瘤临床, 2013, 40(6): 358-362.
引用本文: 张利卜, 徐文贵, 汪莹, 戴东, 马文超, 朱研佳, 门晓媛. PET/CT纵隔淋巴结SUVmax与N0~N 1期非小细胞肺癌手术患者预后相关性的研究[J]. 中国肿瘤临床, 2013, 40(6): 358-362.
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Li-bu ZHANG, Wen-gui XU, Ying WANG, Dong DAI, Wen-chao MA, Yan-jia ZHU, Xiao-yuan MEN. Prognostic value of mediastinal lymph node SUVmax for patients with postoperative N0 ~N1 stage non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(6): 358-362.
Citation: Li-bu ZHANG, Wen-gui XU, Ying WANG, Dong DAI, Wen-chao MA, Yan-jia ZHU, Xiao-yuan MEN. Prognostic value of mediastinal lymph node SUVmax for patients with postoperative N0 ~N1 stage non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2013, 40(6): 358-362.
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PET/CT纵隔淋巴结SUVmax与N0~N 1期非小细胞肺癌手术患者预后相关性的研究

Prognostic value of mediastinal lymph node SUVmax for patients with postoperative N0 ~N1 stage non-small cell lung cancer

    摘要
  • 摘要:
      目的  评价NSCLC患者行根治性切除术后, 纵隔淋巴结组织学检查阴性(N0~N1期)的患者术前纵隔淋巴结FDG摄取水平对患者预后的意义。
      方法  回顾性总结了2005年4月至2009年5月在天津医科大学附属肿瘤医院行PET/CT检查后接受手术治疗的N0~N1期NSCLC患者的PET/CT数据、术后随访资料及临床资料。运用Kaplan-Meier法及Log-rank检验对纵隔淋巴结SUVmax以及性别、年龄、组织学类型、TNM分期、术后辅助治疗、原发病灶SUVmax等分别与患者生存时间进行单因素生存分析, 采用Cox回归风险比例模型对影响预后的各因素进行多因素生存分析。
      结果  单因素分析表明, 术前PET/CT纵隔淋巴结SUVmax(P=0.001)以及TNM分期(P < 0.001)、原发病灶SUVmax(P=0.001)、是否有术后辅助治疗(P=0.012)对N0~N1期NSCLC患者术后预后存在预测作用; 多因素分析表明, 只有TNM分期(P=0.017)、原发病灶SUVmax(P=0.027)及纵隔淋巴结SUVmax(P=0.046)是影响本组NSCLC患者术后生存的独立预后因素, 三者的相对危险度分别为2.230, 2.179及1.962。
      结论  对于N0~N1期的NSCLC术后患者, 术前PET/CT纵隔淋巴结SUVmax、TNM分期、原发病灶SUVmax均是影响患者术后生存的因素。将三者结合起来, 对于指导临床尽早制定术后个体化治疗方案、延长患者生存期具有重要意义。

     

    Abstract:
      Objective  This study assesses the prognostic significance of the uptake level of mediastinal lymph nodes of fluo- ro-2-deoxy-D-glucose in patients undergoing curative resection of non-small cell lung cancer (NSCLC) who have histologically nega- tive mediastinal lymph nodes (N0-N, stage).
      Methods  Preoperative positron emission tomography/computerized tomography (PET/CT) data and clinical follow-up materials of patients who underwent curative surgery with pathologic No-NL stage of NSCLC at the Tianjin Medical University Cancer Hospital from April 2005 to May 2009 were reviewed, Maximum standardized uptake value (SUVmax) of mediastinal lymph nodes and primary tumor, as well as gender, age, histologic type, tumor-node-metastasis (TNM) stage, and postopera- tive adjuvant therapy, were compared to determine their association with patient survival. Kaplan-Meier method and log-rank test were used in the univariate analysis and Cox proportional hazard regression model was used in the multivariate analysis.
      Results  For the N0-N NSCLC patients, univariate analysis showed that SUVmax of mediastinal lymph nodes (P= 0.001), TNM staging (P < 0.001), SUVmax of primary tumor (P=0.001), and postoperative adjuvant therapy (P=0.012) were significant predictors of survival. Multivariate anal- ysis showed that TNM staging (P=0.017) and SUVmax of primary tumor (P=0.027) and mediastinal lymph nodes (P=0.046) were inde- pendent predictors of survival with relative risks of 2.230, 2.179, and 1.962, respectively.
      Conclusion  According to the SUVmax of medi- astinal lymph nodes in the preoperative PET/CT imaging and TNM staging, SUVmax of primary tumor is the predictor for N0-N NSCLC patient survival. These results have important implications for guiding individual treatment after surgery and for prolonging patient sur- vival.

     

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