| Objective:(1)Through the large sample analysis to explore the correlation of primary lung cancer lesions’SUV in PET/CT imaging and gender, age, location, anatomical type, pathology, maximum diameter and CT value of the tumor, clinical stage, tumor markers level.(2)To assess the prognostic significance of primary lesions’and mediastinal lymph nodes’ SUV in patients undergoing curative resection of TN0-1M0stage NSCLC patients.Methods:(1)436lung cancer patients’clinical, pathological and PET/CT data was reviewed retrospectively, who did the PET/CT examination from September2005to December2012in Tianjin Medical University Cancer Hospital and were confirmed by post-surgical biopsy or follow-up. Use SPSS19.0for statistical analysis. SUV of different gender, age, location, anatomical type, levels of tumor markers was compared using independent-sample T test. SUV of different lobe, pathology, maximum diameter, clinical stage was compared using one-way ANOVA. Correlation between SUV and age, maximum diameter, CT value, tumor markers level was analysed using Pearson correlation analysis. Correlation between SUV and gender, location, anatomical type, pathology, clinical stage was analysed using Spearman rank correlation analysis. Bring gender, age, location, anatomical type, pathology, maximum diameter, CT value, clinical stage into multiple regression and correlation analysis. a=0.05.(2)The preoperative PET/CT data, clinical follow-up materials of the patients who underwent curative surgery with TNo-1M0stage NSCLC at Tianjin Medical University Cancer Hospital from April2005to May2009were reviewed retrospectively. The mediastinal lymph nodes’ SUV, in addition with gender, age, pathology, TNM staging, postoperative adjuvant therapy, primary tumor’s SUV were compared for their possible association with patients’ survival, using the Kaplan-Meier method and Log-rank test in the univariate analysis and the Cox proportional hazard regession model in the multivariate analysis.Results:(1) Difference between SUV of different gender was statistically significant(male12.16±6.68, female9.96±4.48, P<0.001). Difference between SUV of different age groups was statistically significant(<60years10.35±5.31,>60years11.84±6.80. P<0.05). Difference between SUV of different location was statistically significant(left lung12.04±6.70, right lung10.72±5.97, P<0.05). Difference between SUV of different lobes was not statistically significant(.P=0.063). Difference between SUV of different anatomical types was statistically significant (central13.95±6.17, peripheral10.91±6.25, P<0.001). Difference between SUV of squamous cell carcinoma and adenocarcinoma, others was statistically significant(adenocarcinoma9.14±5.60, squamous cell carcinoma14.55±6.66, others8.84±3.66, P<0.001). Difference between SUV of adenocarcinoma and others was not statistically significant(P=0.813). Difference between SUV of different maximum diameter was statistically significant (≤3cm8.69±4.90,>3cm and<7cm13.32±6.47,>7cm16.61±6.44, P<0.05). Difference between SUV of different clinical stages was statistically significant (stage Ⅰ8.63±5.67, stage Ⅱ10.23±5.37, stage Ⅲ12.45±6.77, stage Ⅳ12.53±6.19, P<0.001). Difference between SUV of normal and high CEA group was not statistically significant(11.38±6.61,11.97±5.61, P=0.442). Difference between SUV of normal and high Cyfra21-1group was statistically significant (10.70±6.16,12.44±6.04, P=0.021). Difference between SUV of normal and high SCC group was statistically significant(10.69±5.35,14.76±7.33, P=0.001). Difference between SUV of normal and high NSE group was not statistically significant11.29±6.18,12.68±5.96, P=0.095). Difference between SUV of normal and high adenocarcinoma CEA group was statistically significant(7.82±6.02,11.45±5.10, P=0.001). Difference between SUV of normal and high squamous cell carcinoma Cyfra21-1group was not statistically significant(14.53±6.12,16.04±6.5, P=0.405). Difference between SUV of normal and high squamous cell carcinoma SCC group was statistically significant(13.84±4.95,17.41±7.24, P=0.028). Correlation between SUV and age, maximum diameter, CT value, level of Cyfra21-1, SCC, squamous cell carcinoma SCC was statistically significant (P=0.041,<0.001,0.002,0.001,0.001,0.024and r>0). Correlation between SUV and CEA, NSE, adenocarcinoma CEA, squamous cell carcinoma Cyfra21-1was not statistically significant(P=0.202,0.967,0.929,0.434). Correlation between SUV and gender, anatomical type, pathology, clinical stage was statistically significant(P=0.001,<0.001,<0.001,<0.001). Correlation between SUV and location was not statistically significant(P=0.051). Regression coefficient between SUV and age, pathology, maximum diameter, clinical stage was statistically significant(P=0.017,<0.001,<0.001,<0.001).(2) Univariate analysis showed that, for the TN0-1M0stage NSCLC patients, mediastinal lymph nodes’SUV(P=0.001), TNM staging(P<0.001), primary tumor’s SUV(P=0.001) and postoperative adjuvant therapy(P=0.012) were significant predictors of survival. Multivariate analysis demonstrated that TNM staging(P=0.017), primary tumor’s SUV(P=0.027) and mediastinal lymph nodes’ SUV(P=0.046) were independent predictors of suivival, with the relative risk of2.230,2.179and1.962.Conclusion:(1) For lung cancer patients primary lesions’SUV:male is higher than female patients.<60years is lower than>60years. Left lung is higher than right lung. Different lobes show no significant differences. Central cancer is higher than peripheral. Squamous cell carcinoma is higher than adenocarcinoma and others. Differences between adenocarcinoma and others was not significant. Maximum diameter<3cm is lower than>3cm and<7cm, and maximum diameter>3cm and <7cm is lower than>7cm. Stage Ⅰ, stage Ⅱ are lower than stage Ⅲ and stage Ⅳ, but differences between stage Ⅰ and Ⅱ, Ⅲ and IV are not significant. High Cyfra21-1and SCC level is higher than normal. Differences between high and normal CEA, NSE level is not significant. High adenocarcinoma CEA level is higher than normal.High squamous cell carcinoma SCC level is higher than normal. Differences between high and normal squamous cell carcinoma Cyfra21-1level is not significant. There is correlation between SUV and gender, age, anatomical type, pathology, maximum diameter, CT value, clinical stage, SCC level, Cyfra21-1level, squamous cell carcinoma SCC level. There is no correlation between SUV and location, CEA level, NSE level, adenocarcinoma CEA level, squamous cell carcinoma Cyfra21-1level. Age, pathology, maximum diameter, clinical stage are the independent impact factors of primary lesion’s SUV. The impact degree is maximum diameter> pathology>clinical stage>age. Gender, location, anatomical type, pathology and CT value could not influence primary lesion’s SUV independently.(2) For TN0-1M0stage NSCLC patients who underwent curative surgery, TNM stage, the primary lesion’s SUV and mediastinal lymph nodes’ SUV are independent prognostic factors. |
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