| Objective Esophageal cancer is a common malignant tumor of the digestive tract in the world.Traditional imaging diagnostic methods include gastrointestinal imaging,CT,endoscopic and endoscopic ultrasonography.PET / CT is an emerging imaging technique that includes functional metabolism and anatomical imaging.It is widely used in the diagnosis,staging,therapeutic evaluation and prognosis evaluation of esophageal cancer.Metabolic parameters of PET / CT imaging have become a hot spot in the clinical prognosis of cancer patients in recent years.Radiotherapy is an important treatment of esophageal cancer,especially for patients with locally advanced esophageal cancer,radiotherapy can significantly improve the patient’s life treatment and overall survival.The purpose of this study was to investigate the value of 18F-FDG PET / CT imaging before radiotherapy as a prognostic indicator in patients with esophageal cancer.Methods The clinical data of 37 patients with esophageal squamous cell carcinoma of stage II ~ IIII who were admitted to Anhui Provincial Hospital to accepted PET/CT examination before radiotherapy in 2010 ~ 2015 were analyzed retrospectively.The age,sex,primary lesion,TNM staging and treatment plan were collected.SUVmax,MTV,PTL,and TLG were calculated.The optimal thresholds of SUVmax,MTV,TLG,PTL were found by receiver operating characteristic curve.The Kaplan-Meier method was used to calculate survival rates,the logrank was used to examine differences and univariate analysis.COX regression models were used to analyze multivariate statistical analysis of meaningful clinical variables.Results The survival time of 37 patients with esophageal cancer was 8 to 65 months,the median survival time was 23 months,and the average survival time was 21.4 months.The overall survival rates at 1,2 and 3 years were 73%,35% and 8%,respectively.The area under the ROC curve suggested MTV> TLG> PTL> SUVmean> SUVmax = 0.713> 0.679> 0.670> 0.521> 413.According to the Jouden index,the optimal MTV was 27.44 ml,SUVmax was 11.84,TLG was 166.2g,PTL was 36.74 mm,SUVmean 4.59,and divided into high group and low group according to the optimal cut-off value.Kaplan-Meier survival analysis showed that patients had better survival when MTV was less than 27.44 ml,TLG was less than 166.2 and PTL was less than 36.74mm(P<0.05);SUVmax,age,sex,different primary lesion,and chemotherapy was not statistically significant(P>0.05).Univariate analysis showed that MTV,TLG,PTL,SUVmean,clinical stage and T stage were independent predictors of prognosis.Multivariate regression analysis showed that MTV was an independent risk factor for radiotherapy prognosis in esophageal cancer patients(P = 0.000)The relative risk(RR)of the group was 9.209 times lower than that of the low group,and the 95% CI of RR was(3.150 ~ 26.919).Conclusion Combined with the above findings,there was a certain relevance between PET/CT imaging before radiotherapy metabolic parameters and clinical prognosis of patients with esophageal cancer.In particular,MTV,TLG,PTL and SUVmean are important predictors of patient outcome.PET/CT imaging before radiotherapy metabolic parameters of esophageal cancer patients is important,including the selection and adjustment of treatment options to improve patient survival and improve prognosis. |
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