摘要
目的探讨^(18)F-FDG PET/CT不同代谢参数预测结直肠癌KRAS基因突变的作用。资料与方法回顾性分析52例经手术或内镜活检病理证实的结直肠癌患者的临床、病理及PET/CT资料。分析血清癌胚抗原(CEA)及血清糖链抗原-199(CA199)等临床病理参数水平、病理特征、肿瘤-淋巴结-转移(TNM)分期及最大标准化摄取值(SUV_(max))、平均标准化摄取值(SUV_(mean))、标准化摄取峰值(SUV_(peak))、代谢肿瘤体积(MTV)、糖酵解总量(TLG)等PET/CT代谢参数与KRAS基因突变状态的关系;利用受试者工作特征(ROC)曲线分析获得PET/CT代谢参数的最佳阈值。结果KRAS基因突变型15例,野生型37例,两组患者性别、年龄、原发肿瘤部位、分化程度、病理类型、TNM分期、肿瘤长径、CEA水平及CA199水平比较,差异均无统计学意义(P>0.05)。与KRAS野生型相比,KRAS突变型患者SUV_(max)(13.37、19.00)、SUV_(mean)(7.74、11.11)、SUV_(peak)(9.38、14.09)显著升高,差异均有统计学意义(Z=-2.171、-2.091、-2.050,P<0.05)。两组MTV及TLG差异无统计学意义(Z=-0.757、-1.262,P>0.05)。以17.17、10.31和13.03为阈值时,SUV_(max)、SUV_(mean)、SUV_(peak)的ROC曲线下面积分别为0.694、0.686和0.683,诊断KRAS基因突变的敏感度均为66.7%,特异度为75.7%-81.1%,准确度为73.1%76.9%。结论^(18)FFDG PET/CT代谢参数对结直肠癌KRAS基因突变有一定的预测作用。
Purpose To investigate the role of different metabolic parameters of 18F-FDG PET/CT in predicting KRAS gene mutations in patients with colorectal cancer. Materials and Methods The clinicopathological features and PET/CT images of 52 patients with colorectal cancer confirmed by surgery or endoscopic biopsy were retrospectively analyzed. The clinical parameters including serum carcinoembryonic antigen(CEA) and serum sugar chain antigen 199(CA199) levels, pathological characteristics, tumor-node-metastasis(TNM) staging system were analyzed. And the relationship between PET/CT metabolic parameters including the maximum standardized uptake value(SUVmax), the mean standardized uptake value(SUVmean), the peak standardized uptake value(SUVpeak), metabolic tumor volume(MTV), total lesion glycolysis(TLG) and state of KRAS mutations were further evaluated. The receiver-operating characteristic(ROC) curve analysis was performed to obtain the best threshold value of PET/CT metabolic parameters. Results There were 15 patients with KRAS gene mutation and 37 patients with wild-type. There were no statistically significant differences in gender, age, primary tumor site, degree of differentiation, pathological type, TNM stage, tumor length and diameter, CEA and CA199 levels between the two groups(all P>0.05). The SUVmax(13.37, 19.00), SUVmean(7.74, 11.11) and SUVpeak(9.38, 14.09) of KRAS mutant were significantly higher than those of KRAS wild type(Z=-2.171,-2.091 and-2.050, P<0.05). There was no significant difference in MTV and TLG between these two groups(Z=-0.757 and-1.262, P>0.05). Based on the different level of thresholds such as 17.17, 10.31 and 13.03, the areas under the curve of SUVmax, SUVmean and SUVpeak were 0.694, 0.686 and 0.683, respectively. The sensitivity, specificity and accuracy of KRAS mutation diagnosis were all 66.7%, 75.7%-81.1% and 73.1%-76.9%, respectively. Conclusion 18F-FDG PET/CT has a certain predictive effect on KRAS gene mutation in patients with colorectal cancer patients.
作者
刘昕
倪明
张依凡
潘博
汪世存
吕维富
LIU Xin;NI Ming;ZHANG Yifan;PANBo;WANG Shicun;LV Weifu(Department of Nuclear Medicine,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China;不详)
出处
《中国医学影像学杂志》
CSCD
北大核心
2021年第6期591-595,共5页
Chinese Journal of Medical Imaging
基金
安徽省自然科学基金面上项目(1808085MH254)。
