Correlation Researches Of ¹⁸F-FDG PET/CT Between Clinical Related Factors And Prognosis Of Epithelial Ovarian Cancer

Objective: ovarian cancer is highly malignant tumor in female reproductive system,and its mortality is the first in female malignant tumor,the prognosis were baddish.There are many pathological types of ovarian cancer,epithelial ovarian cancer accounts for the majority.18 F fluorodeoxyglucose positron emission tomography/computed tomography is increasingly used in the diagnosis of ovarian cancer.The purpose of this study was to retrospectively analyze the 18F-FDG PET/CT imaging of 32 patients treated with surgery and chemotherapy,and 14 patients treated with chemotherapy alone.To investigate the application value of 18F-FDG PET/CT in predicting prognosis of patients with epithelial ovarian cancer.Methods:(1)Analyze from September 2008 to June 2015 suspected suffering ovarian cancer which had accepted the PET/C T examination in the Tianjin cancer hospital retrospectively.These patients with clinical stage III or stage IV,later confirmed by pathology after surgery.We obtained FIGO staging,C A125,pathological differentiation,18F-FDG PET/CT data and follow-up data of these patients.All patients were treated by operation and 4~6 chemotherapy after operation.The lesions in the ovary were selected as target lesions.Using Cox proportional hazard regression model analyze the relationship between each patient target lesion maximum standard uptake value(SUVmax),the average standard uptake value(SUVmean),metabolic tumor volume(MTV),total lesion glycolysis(TLG)and other clinical and pathological factors of patients with progression free survival(PFS).The survival rate was analyzed by Kaplan-Meier method with statistical significance.Objective to analyze the relationship between SUVmax and FIGO staging,pathological differentiation,age and CA125.Test level alpha =0.05.(2)Analyze the patients from September 2008 to June 2015 which confirmed by biopsy for epithelial ovarian cancer and only 9~11 times of chemotherapy,.18F-FDG PET/CT examination was performed before and after chemotherapy for 5-7 times.CA125,18F-FDG PET/CT data and follow-up data were obtained.The progression free survival(PFS)was correlated with patient age,CA125 level,and SUVmax,SUVmean,MTV,and TLG levels during treatment,using Pearson correlation analysis.Results:(1)Cox multivariate analysis showed that FIGO stage(P=0.025)and target lesion SUVmax(P<0.01)were independent prognostic factors for survival in patients with epithelial ovarian cancer.Age(P=0.330),C A125(p=0.159),SUVmean(P=0.540),MTV(P=0.865)and tumor cell differentiation(P=0.512)were not significantly associated with the prognosis of patients.Survival analysis showed that progression free survival was significantly shorter with increasing SUVmax(X2=17.286,p<0.01),and the progression free survival of patients with stage FIGO IV was shorter than that of stage III(X2=9.304,p=0.025).The degree of pathological differentiation was statistically significant(SUVmax = 2.88)between the differentiation group(13.05±5.76)and the low differentiation group(7.02±2.88)(p=0.01).There was a significant difference in SUVmax value between FIGO stage and III stage(9.50±4.49)and FIGO stage(14.56±6.22)(p=0.013).There was no significant difference between the SUVmax of the ages less than 52 years old(11.14±6.31)and the age greater than or equal to 52 years old(12.17±5.41).There was no significant difference between the SUVmax of group of CA125<600(11.35±5.80)and CA125 ?600(11.90±5.94).(2)The progression free survival(PFS)of patients with epithelial ovarian cancer(p=0.012)was significantly correlated with the decrease rate of SUVmax,the decrease rate of SUVmean and the decrease of MTV during chemotherapy,and the correlation coefficient was statistically significant(P=0.004,p=0.008).Conclusion: The combination of CT images and PET images with the advantages of PET/CT fusion image can predict the prognosis of patients with ovarian cancer.For patients treated with surgery,the target SUVmax before treatment can be used as an independent predictor of prognosis in patients with epithelial ovarian cancer.Survival analysis showed that the progression free survival time was significantly shortened with the increase of SUVmax.With the decrease of the degree of pathological differentiation,the SUVmax of the target lesion before treatment increased.There was no significant relationship between target SUVmax and age,CA125.Epithelial ovarian cancer patients for chemotherapy in progression free survival with chemotherapy decreased SUVmax rate,SUVmean rate of decline,the decline rate of MTV is significantly decreased,the greater the degree of progression free survival is longer,the better the prognosis.18F-FDG PET/CT has a good application value in the prognosis of patients with epithelia l ovarian cancer,which is helpful to guide the formulation of the treatment plan and the evaluation of the effect of chemotherapy,so as to improve the prognosis of the patients.