{"_":"基线18F-FDG PET/CT代谢定量参数对壶腹腺癌患者的预后意义。","sup":["18"]}

摘要(中文译文)

术前预后预测对壶腹癌患者具有重要意义。壶腹腺癌的预后因素研究较少，尤其是PET/CT代谢参数。本研究旨在探讨基线18F-FDG PET/CT定量代谢参数在壶腹腺癌患者中的预后意义。分析壶腹腺癌患者的临床特征、组织病理学特征及PET/CT定量参数。采用Cox比例风险回归分析确定肿瘤进展或患者生存的独立预测因素。采用Kaplan-Meier曲线评估无进展生存期（PFS）和总生存期（OS），采用log-rank检验比较生存差异。本回顾性研究纳入52例壶腹腺癌患者（男性28例，女性24例），中位年龄64岁。1年、2年和5年PFS分别为69.2%、61.5%和59.6%，OS分别为90.4%、78.8%和76.9%。多因素回归分析显示，原发肿瘤病灶的PET/CT体积参数总病灶糖酵解（TLG）[风险比（HR）：9.306，p<0.001]和组织学分化分级（HR：3.477，p=0.007）是PFS的预测因素。此外，TLG（HR：9.033，p=0.046）和肿瘤大小（HR：6.977，p=0.018）是预测OS的显著变量。本研究表明，原发肿瘤病灶的PET体积参数TLG可作为壶腹腺癌患者PFS（联合组织学分化）和总生存期（联合肿瘤大小）的潜在预后生物标志物。

Abstract

Preoperative prognosis prediction is of significance for ampullary cancer patients. The prognostic factors of ampullary adenocarcinoma have been rarely studied, particularly the PET/CT metabolic parameters. This study aimed to investigate the prognostic significance of quantitative metabolic parameters on baseline F-FDG PET/CT scans in patients with ampullary adenocarcinoma. The clinical characteristics, histopathological features, and quantitative PET/CT parameters of ampullary adenocarcinoma patients were analyzed. Cox proportional hazard regression analyses were performed to identify independent predictors for tumor progression or patient survival. Progression free survival (PFS) and overall survival (OS) were evaluated using the Kaplan-Meier curves, and survival differences were compared using the log-rank test. This retrospective study enrolled fifty-two ampullary adenocarcinoma patients (28 men, 24 women) with a median age of 64 years. The 1-year, 2-year, and 5-year PFS were 69.2%, 61.5%, and 59.6%, while OS were 90.4%, 78.8%, and 76.9%, respectively. Multivariate regression analyses revealed that the PET/CT volumetric parameter total lesion glycolysis (TLG) [hazard ratio (HR): 9.306, p < 0.001] and histologic differentiation grade (HR:3.477, p = 0.007) of the primary tumor lesion were predictive factors for PFS. Besides, TLG (HR:9.033, p = 0.046) and tumor size (HR:6.977, p = 0.018) were significant variables for predicting the OS. The present study demonstrated that the PET volumetric parameter TLG of the primary tumor lesion emerged as a potential prognostic biomarker for PFS (together with histologic differentiation) and for overall survival (together with tumor size) of patients with ampullary adenocarcinoma.

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