Value Of PET/CT In Predicting Outcome And Lymph Node Staging Of Patients With Resected Lung Cancer

Background;The outcome of surgically treatment in non-small lung cancer (NSCLC)remains poor.One of the reasons is that in many patients its biological behavior does not follow a definite pattern,and can not be accurately predicted prior to treatment.It has been reported that ¹⁸F-fluoro-2-deoxy-glucose(¹⁸F- FDG)uptake on PET is associated with tumor aggressiveness in NSCLC.The maximum standardized uptake value(SUV_max,a semi-quantitative measurement of FDG uptake on PET,could thus be of prognostic significance.In the present study,we focused on the role of ¹⁸F- FDG uptake in predicting the outcome of surgically treated patients with NSCLC.Methods;A retrospective analysis was performed on 82 cases of patients who received complete resection and preoperative FDG PET imaging.The maximum standardized uptake value(SUV_max),in addition with five clinicopathological factors and three biomolecular factors that could possibly influence survival were compared for their possible association with patients recurrence and survival,using the Log-Rank test in univariate analysis and the Cox proportional hazards model in multivariate analysis.Association between SUV_maxand other factors was also analyzed.Results;Patients with SUV_maxmore than 11 had shorter disease-free survival and overall survival than patients less than 11 in univariate analyses(P＜0.001 and P=0.002).In the multivariate analyses,SUV_max(dichotomized by 11)was the only significant predictor for tumor recurrence.TNM stage and SUV_max(dichotomized by 11)were independent predictors for overall survival.Associations of SUV_maxwith P53 overexpression,PCNA labeling index and microvascular density in tumor were seen significantly in the entire group. Conclusions;¹⁸F-FDG uptake on PET may be used to noninvasively assess NSCLC biological aggressiveness in vivo,identifying surgically-treated NSCLC patients with poor prognosis that could benefit from additive therapy. Objective;To investigate whether F-fluorodeoxyglucose(FDG)uptake within the primary tunmor correlates with clinicopathological factors in patients with resected non-small-cell lung cancer.Methods;A retrospective analysis was performed on 82 cases of patients who received complete resection and preoperative FDG PET imaging.The maximum standardized uptake value(SUV_max),in addition with clinicopathological factors that could possibly influence survival were compared for their possible associationResults;Associations.of SUV_maxwith P53 overexpression,PCNA labeling index and microvascular density in tumor were seen significantly in the entire group.The appearance of local nodal metastasis were seen more frequently in high SUV group than low group.No corrrelation were found between SUV and other factors.Conclusions;¹⁸F- FDG uptake on PET/CT may be used to noninvasively assess NSCLC biological propagation and aggressiveness in vivo,identifying surgically-treated NSCLC patients with poor prognosis that could benefit from additive therapy. Background;Lung cancer continues to be the most common causes of death by cancer in China.Non-small-cell lung cancer(NSCLC)accounts for 80% of all lung cancer and has the potential for surgical cure once detected at early stage.Optimum management of patients with NSCLC depends on accurate staging.Various diagnostic techniques and procedures are used for preoperative staging of NSCLC,including CT, mediastinoscopy,thoracoscopy,and positron emission tomography(PET).Among the noninvasive diagnostic method,CT is still considered the "gold standard" for the staging of regional lymph node in NSCLC.Unfortunately,the sensitivity of CT is approximately 60% in this region,which is certainly not optimal for clinical decision making.Positron emission tomography(PET)with ¹⁸F-fluoro-2-deoxy-glucose(¹⁸F-FDG)is a noninvasive imaging modality that provides metabolic information useful for tumor imaging.Increased glucose utilization by malignant cells results in increased FDG accumulation,which can help identify malignant abnormalities.We performed this study to determine whether ¹⁸F- FDG PET/CT is reliable for the evaluation of regional lymph nodes in patients with NSCLC.Method;Imaging and clinical findings obtained during 2 years in 79 patients were reviewed.Patients had thoracic computed tomography findings,¹⁸F- FDG PET/CT,and histopathologic proof of NSCLC.At the time of diagnosis,disease stage was assigned on the basis of FDG PET/CT results and compared with the histopathologic stage to determine the accuracy of PET/CT.Results;According to the pathologic results,47 patients had regional lymph nodes metastasis,41 of whom were correctly identified by FDG PET/CT,and 26 by CT.Of the other 32 patients without lymph nodes metastasis pathologically,30 were correctly diagnosed by FDG PET/CT and 28 by CT.The sensitivity and accuracy for diagnosis of regional lymph nodes metastasis with FDG PET/CT were 87.2% and 90.0%,obviously higher than those of CY(55.3% and 68.4%,P＜0.05).Conclusion;FDG PET/CT is a better alternative for lymph node staging to provide important evidence for clinical staging and treatment planning of NSCLC.