| Objective Based on the analysis of positron emission tomography/computed tomography(PET/CT)data in 91 patients with non-small-cell lung cancer(NSCLC),we explored(1)The relationship between 18F-fluoro-2-deoxyglucose(18F-FDG)PET/CT metabolic parameters(SUVmax,MTV,TLG,MTVwb,TLGwb)and clinical factors;(2)To explore the application value of 18F-FDG PET/CT metabolic parameters in the prognosis of NSCLC.Methods A retrospective analysis was performed on the whole body 18F-FDG PET/CT examination in the Department of Nuclear Medicine of the General Hospital of Ning Xia Medical University from January 2013 to December 2018 due to lung occupation.Case data of 91 patients who were confirmed pathologically by NSCLC.The clinical parameters were compared with the metabolic parameters of tumor lesions using independent sample non-parametric tests.Multiple linear regression analysis was performed for statistically significant clinical factors.Using the final follow-up results(survival or death,disease progression or no progression)as the gold standard,the ROC curve calculates the optimal threshold for predicting OS and PFS in non-small cell lung cancer patients with metabolic parameters;Kaplan-Meier method is used to estimate the median survival time and plot Survival curve;Log-rank method was used to test the survival curve between OS and PFS;Cox proportional hazards regression model was used to analyze single and multi-factor prognosis,and independent prognostic factors were screened;P<0.05 was considered statistically significant.Results 1.Of the 91 NSCLC patients,53 were male and 38 were female.Aged26 to 86 years,mean age 61.12 years ± 10.87 years,34 cases <60 years,57 cases ≥60 years;25 cases of squamous cell carcinoma,66 cases of adenocarcinoma;22cases of stage I + II,10 cases of stage III,IV 59 cases.Ki67 results were detected in 57 of the 91 patients,23 in the low-level group and 34 in the high-level group.2.The differences in SUVmax of tumor lesions between different age groups,different gender groups,different pathological types,and different levels of Ki67 were statistically significant,P=0.015,0.008,0.000,and 0.000.There was a statistically significant difference in MTV of tumor lesions between different levels of Ki67,P=0.029.There were statistically significant differences in TLG of tumor lesions between different gender groups,different pathological type groups,and different levels of Ki67,P=0.006,0.014,0.002.There were significant differences in MTVwb and TLGwb between different clinical staging groups,P=0.000,0.001.Pairwise comparison,the differences in MTVwb and TLGwb between the I + II and IV groups were statistically significant,P=0.000,0.001.3.Pathological type,Ki67 expression level,and age were all independent influence factors of SUVmax(standardized partial regression coefficients=0.458,0.344,0.226,P=0.000,0.002,0.028).The influence of pathological type on SUVmax of tumor lesions was higher than Ki67 expression level and age.Ki67 expression level is an independent influence factor of TLG(standardized partial regression coefficient=0.291,P=0.028).4.91 NSCLC patients with metabolic parameters SUVmax,MTV,TLG,MTVwb,and TLGwb predicted the best cutoff values for OS were7.76,13.74cm3,46.69 g,22.55cm3,and 205.09g;the areas under the curve were 0.638,0.581,0.626,0.709 and 0.723 respectively.The optimal parameters for predicting PFS of metabolic parameters SUVmax,MTV,TLG,MTVwb,and TLGwb in 91 NSCLC patientswere 5.79,5.52cm3,13.42 g,22.55cm3,70.82 g,and the areas under the curve were0.642,0.743,0.731,0.821,and 0.802.5.The optimal threshold of metabolic parameters was used to divide them into low value group and high value group.The differences in median OS and PFS between the SUVmax,TLG,MTVwb,and TLGwb groups were statistically significant.P=0.020,0.009,0.000,0.000.The difference in median PFS between MTV 2 groups was statistically significant,P=0.042.6.The results of univariate analysis of COX proportional hazard regression model showed clinical stage(P=0.001),Ki67 expression level(P=0.029),SUVmax(P=0.000),MTV(P=0.006),TLG(P=0.000),MTVwb(P=0.000)and TLGwb(P=0.000)are risk factors for OS.The multivariate analysis of the COX proportional hazard regression model showed that clinical stage(P=0.002),TLG(P=0.016),and TLGwb(P=0.044)were independent prognostic factors for OS in NSCLC patients.7.The univariate analysis results of the COX proportional hazard regression model showed clinical stage(P=0.000),SUVmax(P=0.001),MTV(P=0.002),TLG(P=0.000),MTVwb(P=0.000),TLGwb(P=0.000)is a risk factor for PFS.The multivariate analysis of the COX proportional hazard regression model showed that clinical stage(P=0.000),TLG(P=0.001),and MTVwb(P=0.009)were independent prognostic factors for PFS in NSCLC patients.Conclusions 1.There are differences in tumor lesion SUVmax between different age groups,different gender groups,different pathological type groups,and different levels of Ki67.The higher the Ki67 expression level,the larger the MTV of the tumor.There were differences in tumor lesion TLG between different gender groups,different pathological type groups,and different levels of Ki67.There are differences in MTVwb and TLGwb between different clinical staging groups.Stages I + II are smaller than stage IV of MTVwb and TLGwb.2.Pathological type,Ki67 expression level,and age are all independent influencing factors of SUVmax.The intensity of the impact is from pathological type,Ki67 expression level,and age from strong to weak.Ki67 expression level is an independent influence factor of TLG.3.The median OS and PFS of SUVmax,TLG,MTVwb,TLGwb low value group and higher value group are longer.There was no significant difference in median OS between the MTV low-value group and the high-value group.The median PFS was longer in the lower value group of the MTV lower value group.4.Clinical stage,tumor focus Ki67,SUVmax,MTV,TLG,MTVwb,TLGwb are risk factors for OS.Clinical stage,TLG,TLGwb are independent prognostic factors of OS.5.Clinical staging,SUVmax,MTV,TLG,MTVwb,TLGwb are risk factors for PFS.Clinical stage,TLG,and MTVwb are independent prognostic factors for PFS in NSCLC patients. |
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