| Objective To investigate the relationship among metabolic parameters,pathological features with prognosis of intramural gastric metastasis(IGM)of esophageal squamous cell carcinoma.Methods Totally 86 cases of IGM treated in our hospital from January 2008 to December2014 were included in the study.Basic information and clinical data were recorded,including gender,age,location of esophageal cancer,tumor diameter,lymph node metastasis,distant metastasis and TNM stage.The whole patients were examined by PET-CT.The maximum standard uptake value(SUVmax),the metabolic tumor volume(MTV),the PET tumor length(PTL),and the average standard uptake value(SUVmean)of IGM were measured.The total glycolysis(TLG)and other metabolic parameters were calculated.After the examination was completed,radical resection of esophageal cancer was performed.All patients were followed up for 5 years after the treatment,and the survival of the patients during the 5-year follow-up were recorded.Pearson correlation analysis was used to analyze the relationship between metabolic parameters and clinicopathological parameters;Kaplan-Meier curve was drawn to analyze the survival of patients;ROC curve was used to determine the optimal value of metabolic parameters;univariate analysis and COX multivariate analysis were used to analyze the influencing factors of prognosis.Finally,the relationship between metabolic parameters and pathological characteristics of esophageal squamous cell carcinoma and prognosis of intramural gastric metastasis was analyzed.Results The average diameter of primary lesion in IGM patients with esophageal squamous cell carcinoma was(4.91±1.83)cm.PET-CT imaging showed that SUVmax was(9.87±4.96),MTV was(12.27±+6.23)cm~3,TLG was 4.02(18.31,111.65)g and SUVmean was(5.97±3.19).SUVmax and SUVmean of IGM were related to the diameter of the primary tumor(P<0.05);MTV was associated with the tumor diameter,lymph node metastasis,and TNM staging(P<0.05).TLG was associated with the tumor diameter,lymph node metastasis,TNM stage,and tissue differentiation(P<0.05).During the 5-year follow-up,6 patients were lost to follow-up;36 patients died and 4 patients survived,and among them,16 patients died of obstruction,bleeding and asphyxia,13 died of exhaustion and cancer cachexia caused by extensive metastasis of other parts of esophageal squamous cell carcinoma and 7 died of radiation pneumonia and other accidents.The mean survival time was(21.4±4.51)months.Follow-up to 20and 40 months showed the fastest increase in the number of cases with adverse prognosis.ROC curve showed that AUCSUVmax=0.417?AUCMTV=0.721?AUCTLG=0.682?AUCPTL=0.665?AUC SUVmean=0.517.The critical values of the optimal diagnostic parameters were SUVmax=11.79?MTV=27.46 cm3?TLG=165.93g?PTL=37.02?SUVmean=4.61.Univariate analysis of prognosis showed that SUVmax,MTV,TLG,PTL,SUVmean and TNM stages were predictors of prognosis(P<0.05).Multivariate prognostic analysis showed that MTV,TLG,PTL,SUVmean and TNM stages were risk factors for prognosis(P<0.05),while SUVmax was not risk factors for prognosis.Conclusion The metabolic parameters of SUVmax,MTV,TLG,PTL and SUVmean in patients with IGM of esophageal squamous cell carcinoma are related to the pathological characteristics of patients except distant metastasis.They can reflect the volume of primary lesion,lymph node metastasis,TNM stage and histological differentiation of patients with IGM of esophageal squamous cell carcinoma from different aspects.SUVmax,MTV,TLG,PTL,SUVmean and TNM stages are predictors of prognosis.MTV,TLG,PTL,SUVmean and TNM stages in clinical and pathological features are risk factors of prognosis in patients with esophageal squamous cell carcinoma.PET-CT examination has a certain value for prognosis evaluation of patients with IGM. |
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