医学
肺癌
标准摄取值
节的
腺癌
阶段(地层学)
正电子发射断层摄影术
原发性肿瘤
放射科
肺癌分期
T级
癌症
核医学
肿瘤科
内科学
转移
纵隔镜检查
古生物学
生物
作者
Özlem Okumus,K Mardanzai,Till Plönes,Dirk Theegarten,Kaid Darwiche,Martin Schüler,Felix Nensa,Hubertus Hautzel,Ken Hermann,Martin Stuschke,Balázs Hegedũs,Clemens Aigner
出处
期刊:Lung Cancer
[Elsevier]
日期:2022-12-29
卷期号:176: 82-88
标识
DOI:10.1016/j.lungcan.2022.12.013
摘要
Abstract
Objectives
Accurate nodal staging is of utmost importance in patients with lung cancer. FDG-PET/CT imaging is now part of the routine staging. Despite thorough preoperative staging nodal upstaging still occurs in early-stage lung cancer. However, the predictive value of preoperative PET metrics of the primary tumor on nodal upstaging remains to be unexplored. Our aim was to assess the association of these preoperative PET-parameters with nodal upstaging in histologically confirmed lung adenocarcinoma and squamous cell carcinoma. Methods
From January 2016 to November 2018, 500 patients with pT1-T2/cN0 lung cancer received an anatomical resection with curative intent. 171 patients with adenocarcinoma and squamous cell carcinoma and available PET-CTs were retrospectively included. We analyzed the the association of nodal upstaging with preoperative PET-SUVmax and metabolic PET metrics including total lesion glycolysis (TLG) and metabolic tumor volume (MTV) with different defined thresholds. Results
High values of preoperative PET-SUVmax of the primary tumor were associated with squamous cell carcinoma (p <0.0001) and with larger tumors (p<0.0001). Increased preoperative C-reactive protein levels (<1mg/dL) correlated significantly with high preoperative PET-SUVmax values (p <0.0001). No significant relationship between PET-SUVmax and lactate dehydrogenase activity (p=0.6818), white blood cell count (p=0.7681), gender (p=0.1115) or age (p=0.9284) was observed. Nodal upstaging rate was 14.0% with 8.8% N1 and 5.3% N2 upstaging. Tumor size (p=0.0468) and number of removed lymph nodes (p=0.0461) were significant predictors of nodal upstaging but no significant association was found with histology or PET parameters. Of note, increased MTV - regardless of the threshold - tended to associate with nodal upstaging. Conclusion
Early-stage lung cancer patients with squamous histology and T2 tumors presented increased preoperative PET-SUVmax values. Nevertheless, beyond tumor size and number of removed lymph nodes neither SUVmax nor metabolic PET parameters MTV and TLG were significant predictors of nodal upstaging.
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