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目的:初步探讨鼻咽癌18FDGPET代谢活性容积与预后的关系。方法:回顾性分析经病理确诊、有完整随访资料的鼻咽癌初治患者39例,所有患者均有治疗前18FDGPET-CT资料。在PET图像上以标准化摄取值(SUV)=2.5扣本底确定原发灶及阳性淋巴结的边界,计算其代谢活性容积(MAV),所有患者均行根治性调强放疗或同期放化疗。结果:T1、T2、T3和T4期的平均原发灶MAV(MAV-P)分别为(6.86±5.67)、(20.45±16.11)、(34.09±22.35)和(55.38±32.79)cm3,差异有统计学意义,P=0.001。原发灶最高标准化摄取值(SUV-P)为8.33±3.84,各T分期之间差异有统计学意义,P=0.003;MAV-P与SUV-P显著相关,r=0.782,P<0.001。3年局部区域控制率为90.7%(34/39),3年无远地转移生存率为84.7%(31/39),3年无进展生存率为80.5%(28/39)。单因素分析显示,总肿瘤MAV(TMAV)>60cm3、转移淋巴结MAV(MAV-Ln)>30cm3及SUV-P>9.5者3年无远地转移生存率及无进展生存率均显著降低,P<0.05。结论:应用18FDGPET检查获得鼻咽癌MAV是可行的,鼻咽癌TMAV、MAV-Ln和SUV-P均是影响疾病进展及远地转移的预后因素。
Objective: To investigate the relationship between metabolic activity volume and prognosis of nasopharyngeal carcinoma 18FDGPET. Methods: A retrospective analysis of pathologically confirmed, complete follow-up data of 39 cases of nasopharyngeal carcinoma-naive patients, all patients with pre-treatment 18FDGPET-CT data. Metabolic activity volume (MAV) was calculated on the PET image with normalized uptake value (SUV) = 2.5 and the borderline between the primary tumor and the positive lymph node was calculated. All patients underwent radical IMRT or concurrent chemoradiotherapy. Results: The mean primary MAF (MAV-P) at T1, T2, T3 and T4 were (6.86 ± 5.67), (20.45 ± 16.11), (34.09 ± 22.35) and (55.38 ± 32.79) cm3, respectively Statistical significance, P = 0.001. The highest normalized value of primary tumor (SUV-P) was 8.33 ± 3.84, with significant difference between each T stage (P = 0.003); MAV-P was significantly correlated with SUV-P, r = 0.782, P <0.001. The 3-year local regional control rate was 90.7% (34/39), 3-year distant metastasis-free survival rate was 84.7% (31/39), and 3-year progression-free survival rate was 80.5% (28/39). Univariate analysis showed that TMAV> 60cm3, MAV (L-Vp)> 30cm3, and SUV-P> 9.5 in metastatic lymph nodes significantly decreased 3-year distant metastasis-free survival and progression-free survival, P < 0.05. Conclusion: It is feasible to use 18FDGPET to detect MAV in nasopharyngeal carcinoma. TMAV, MAV-Ln and SUV-P of nasopharyngeal carcinoma are both prognostic factors affecting the progression of disease and distant metastasis.