Study On The Relationship Of ¹⁸F-FDG PET/CT And Serum Tumor Markers With Metastasis And Clinical Stage Of Lung Cancer

ObjectiveTo investigate and analyze the relationship of imaging findings,metabolic parameters in ¹⁸F-FDG PET/CT and the serum tumor markers expression with lymphatic metastasis,distant metastasis and clinical staging in patients with lung cancer.MethodsA total of 103 patients with lung cancer diagnosed in our hospital from February 2019 to December 2020 were collected and retrospectively analyzed.All included patients had been pathologically diagnosed.The ¹⁸F-FDG PET/CT whole body imaging were performed and serum tumor markers,such as cytokeratin 19 fragment（Cyfra21-1）,gastrin releasing peptide precursor（pro GRP）,carcinoembryonic antigen（CEA）were detected within 2 weeks before treatment.The imaging performance of ¹⁸F-FDG PET/CT were analyzed.Some metabolic parameters such as the maximum standard uptake value（SUVmax）,average standard uptake value（SUVavg）,peak standard uptake value（SUVpeak）,tumor metabolic volume（MTV）,total lesion glycolysis（TLG）and the standardized average peak difference of intake（△SUV）were measured.The relationship of the metabolic parameters of ¹⁸F-FDG PET/CT and the serum tumor markers expression with lymphatic metastasis,distant metastasis and clinical staging in patients with lung cancer were explored.The logistic regression model was established,and ROC curve analysis was used to determine sensitivity,specificity and area under the curve.Results1.There were no statistically significant differences in the age,gender,pathological type,and left and right lung locations of lung cancer patients between the positive and negative groups of lymph node metastasis,and between the positive and negative groups of distant metastasis（P>0.05）.2.The lymph node metastasis of lung cancer patients with imaging manifestations of lobular sign was significantly higher than that of patients without lobular sign,and the difference was significant（X2=10.285,P=0.001）;The distant metastasis of lung cancer patients with positive vascular clustering signs was significantly higher than that of negative patients,and the difference was significant（X2=16.343,P<0.001）.3.There were significant differences in SUVmax,SUVavg,SUVpeak,△SUV,MTV and TLG between lymph node metastasis group of lung cancer and non-lymph node metastasis group（P<0.05）.There were also significant differences in SUVmax,SUVavg,SUVpeak,△SUV,MTV and TLG between distant metastasis group and non-distant metastasis group（P<0.05）.4.the expression of the tumor marker Cyfra21-1 was significantly higher in the distant metastasis positive group than that in the distant metastasis negative group（Z=-3.734,P<0.001）.5.Logistic regression analysis showed that the lobular sign,maximum cross-sectional diameter,and SUVmax of the lesion were risk factors for lymph node metastasis of lung cancer;The vascular cluster sign and△SUV were risk factors for distant metastasis of lung cancer.6.Spearman correlation test showed that the clinical staging of primary lung cancer had a certain correlation with the maximum cross-sectional diameter of tumor,SUVmax,SUVavg,SUVpeak,△SUV,MTV,TLG,Cyfra21-1 and CEA（P<0.05）.7.Logistic regression analysis results showed that the lesion vascular clustering sign,SUVmax,and Cyfra21-1 were the influencing factors of early stage（I+II）and middle late stage（III+IV）of lung cancer.ConclusionsThe lobular sign,maximum cross-sectional diameter and SUVmax are the influencing factors of lung cancer lymph node metastasis,while the vascular cluster sign and△SUV have important significance in the prediction of distant metastasis of lung cancer.The lesion vascular clustering sign,SUVmax,and Cyfra21-1 are influencing factors of clinical staging.Therefore,the observing and analyzing of ¹⁸F-FDG PET/CT imaging performance,metabolic parameters and the expression of serum tumor markers in patients with lung cancer have an important clinical value for the diagnosis of lymphatic metastasis,distant metastasis and clinical staging.