Objective: To investigate the value of maximum Standardized Uptake Value(SUVmax), Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (TLG) calculated from (18)F-FDG PET-CT in predicting the presence of epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma. Methods: We retrospectively reviewed 137 lung adenocarcinoma patients with EGFR mutations testing and pretreatment (18)F-FDG PET-CT. Receiver Operating Characteristic (ROC) curve analysis was performed to quantify the predictive value of SUVmax、MTV、TLG. A multivariate logistic regression analysis was used to evaluate the predictive value of EGFR mutation. Results: Among 137 lung adenocarcinoma patients, 86(62.8%, 86/137) were identified with EGFR mutations. The SUVmax, MTV and TLG were 7.4, 5.28 cm(3,) 20.20, respectively. The optimal cut-off values of SUVmax, MTV and TLG were 7.99(AUC=0.658, 95% CI=0.566~0.752, P=0.002), 6.09 cm(3)(AUC=0.644, 95% CI=0.550~0.737, P=0.005), 35.08(AUC=0.650, 95% CI= 0.557~0.744, P=0.003), respectively. Multivariate analysis showed that TLG and smoking status were the most significant predictors of EGFR mutation(all P<0.05). Conclusion: TLG in (18)F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with lung adenocarcinoma, and has certain reference value for predicting EGFR mutation.
目的： 探讨(18)F－脱氧葡萄糖((18)F－FDG)正电子发射计算机断层扫描(PET－CT)显像中最大标准摄取值(SUVmax)、代谢体积(MTV)和病灶糖酵解总量(TLG)在预测肺腺癌人表皮生长因子受体(EGFR)突变中的价值。 方法： 回顾性分析137例经手术病理证实的肺腺癌患者的(18)F－FDG PET－CT显像资料和临床病理资料。采用受试者工作特征(ROC)曲线和ROC曲线下面积(AUC)分析SUVmax、MTV、TLG预测EGFR突变的最佳临界值。采用Logistic回归模型进行影响EGFR突变的多因素分析。 结果： 137例肺腺癌患者中，EGFR突变型86例(62.8%)。137例肺腺癌患者的SUVmax、MTV和TLG分别为7.42、5.28 cm(3)和20.20。ROC曲线分析显示，SUVmax、MTV和TLG预测EGFR突变的最佳临界值分别为7.99(AUC＝0.658, 95% CI为0.566～0.752，P＝0.002)、6.09 cm(3)(AUC＝0.644, 95% CI＝0.550～0.737，P＝0.005)和35.08(AUC＝0.650，95% CI为0.557～0.744，P＝0.003)。Logistic多因素分析显示，吸烟和TLG为预测EGFR突变的独立因素(均P<0.05)。 结论： (18)F－FDG PET－CT显像中TLG是预测肺腺癌EGFR突变的独立影响因素，在预测EGFR突变中具有一定的参考价值。.
Keywords: Fluorodeoxyglucose F18; Lung neoplasms; Receptor, epidermal growth factor; Tomography, X-ray computed; Tomography, emission-computed.