Clinical significance of PET/CT uptake for peripheral clinical N0 non-small cell lung cancer.,Cancer Medicine

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Clinical significance of PET/CT uptake for peripheral clinical N0 non-small cell lung cancer.
Cancer Medicine ( IF 2.9 ) Pub Date : 2020-02-13 , DOI: 10.1002/cam4.2900
Shuai Wang ₁ , Dong Lin ₁ , Xiaodong Yang ₁ , Cheng Zhan ₁ , Shihai Zhao ₂ , Rongkui Luo ₃ , Qun Wang ₁ , Lijie Tan ₁

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OBJECTIVE In this cohort study, we determined the clinical value of the maximum standardized uptake value (SUVmax) of primary tumors in non-small cell lung cancer (NSCLC). STUDY DESIGN A retrospective review of NSCLC patients was performed from January 2011 to December 2017. Peripheral cN0 NSCLC patients with tumor size ≤2 cm were included. SUVmax was calculated as a continuous variable for semiquantitative analyses. A receiver operating characteristic curve was analyzed to assess the cutoff threshold of SUVmax on pathological (p) nodal metastasis. We further evaluated the clinical relevance of SUVmax in peripheral cN0 NSCLC patients. RESULTS A total of 670 peripheral NSCLC patients with tumor size ≤2 cm were deemed cN0 by preoperative PET/CT scan. Statistical analyses suggested significant correlations of SUVmax with smoking status (P = .026), tumor volume (P = .001), pathology type (P = .008), tumor differentiation (P < .001), vessel invasion (P = .001), plural invasion (P < .001), pT stage (P < .001), nodal involvement (P < .001), and pathological tumor node metastasis stage (P < .001). A cutoff point of SUVmax of 3.8 (P < .001) could be used to predict pathological nodal metastasis. Multivariable analyses indicated that preoperative SUVmax >3.8 (odds ratio, 12.149; P < .001) was an independent predictor of nodal metastasis. Overall survival analyses further suggested that SUVmax was an independent prognostic indicator (hazard ratio, 2.050; P = .017). CONCLUSION Preoperative SUVmax is a predictor of pathological nodal metastasis and prognosis for peripheral cN0 NSCLC patients with tumor size ≤2 cm. Our results indicate that assessment of PET SUVmax could improve stratification of these patients.

中文翻译：

PET / CT摄取对周围型临床N0非小细胞肺癌的临床意义。

目的在这项队列研究中，我们确定了非小细胞肺癌（NSCLC）中原发性肿瘤的最大标准摄取值（SUVmax）的临床价值。研究设计自2011年1月至2017年12月，对NSCLC患者进行回顾性回顾。研究包括肿瘤大小≤2 cm的周围cN0 NSCLC患者。SUVmax计算为连续变量，用于半定量分析。分析了接收器的工作特性曲线，以评估SUVmax在病理性（p）淋巴结转移方面的临界阈值。我们进一步评估了周围型cN0 NSCLC患者中SUVmax的临床相关性。结果术前PET / CT扫描共将670例肿瘤大小≤2cm的周围型NSCLC患者视为cN0。统计分析表明SUVmax与吸烟状况之间存在显着相关性（P = .026），肿瘤体积（P = .001），病理类型（P = .008），肿瘤分化（P <.001），血管浸润（P = .001），多发性浸润（P <.001），pT分期（P < .001），淋巴结受累（P <.001）和病理性肿瘤结转移阶段（P <.001）。SUVmax的临界值3.8（P <.001）可用于预测病理性淋巴结转移。多变量分析表明，术前SUVmax> 3.8（优势比，12.149； P <.001）是淋巴结转移的独立预测因子。总体生存分析进一步表明SUVmax是一个独立的预后指标（危险比2.050； P = 0.017）。结论术前SUVmax可预测肿瘤大小≤2 cm的周围cN0 NSCLC患者的病理性结节转移和预后。

更新日期：2020-02-14

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