目的 探讨氟脱氧葡萄糖F18正电子发射计算机断层显像(18F-FDG PET-CT)在不可切除肺腺癌表皮生长因子受体(EGFR)突变中的预测价值.方法 收集2012年4月至2016年5月151例ⅢB期或Ⅳ期的肺腺癌患者的临床资料,所有患者治疗前均行18F-FDG PET-CT检查及EGFR突变检测.采用受试者工作特征(ROC)曲线计算最大标准摄取值(SUVmax)的截断值,Logistics回归分析影响EGFR突变的预测因素.结果 ROC曲线分析显示,SUVmax预测EGFR突变的截断值为10.28.151例不可切除肺腺癌患者中,68例(45.0%)为EGFR突变型.单因素分析结果显示,性别、吸烟、癌胚抗原、SUVmax与EGFR突变有关(P<0.05),而CT征象包括空洞、空气支气管征、密度、分叶、胸膜凹陷与EGFR突变无关(P>0.05).Logistic多因素分析显示,吸烟和SUVmax是预测EGFR突变的独立因素(P<0.05).结论 SUVmax是18F-FDG PET-CT预测不可切除肺腺癌EGFR突变的独立因素,在预测EGFR突变中具有一定的参考价值.%Objective To investigate the value of fluorodeoxyglucose F18 positron emission tomography-computed tomography (18F-FDG PET-CT) in predicting the presence of epidermal growth factor receptor (EGFR) mutations in unresectable lung adeocarcinoma.Methods From April 2012 to May 2016, 151 patients with stage ⅢB or Ⅳ lung adeocarcinoma who underwent 18F-FDG PET-CT and EGFR mutation analysis were enrolled in this study.Receiver-operating characteristic (ROC) curve was used to test the cut-off of maximum standard uptake value(SUVmax).Logistic regression model was employed to analyze the independent predictive factors for EGFR mutatuin.Results ROC curve showed that the cut-off of SUVmax was 10.28.Among 151 lung adeocarcinoma patients, 68(45.0%) were identified with EGFR mutation.Univariate analysis showed that gender, smoking status, CEA and SUVmaxwere all associated with EGFR mutation (P<0.05).And no significant differences were found regarding partical CT characteristics of lesions including cavitation, air bronchogram, attenuation, lobulation and pleural-indentation (P>0.05).Logistic multivariate analysis showed that smoking status and SUVmax were the independent factors for predicting EGFR mutation (P<0.05).Conclusion SUVmax of 18F-FDG PET/CT is an independent factor for predicting EGFR mutation in patients with unresectable lung adeocarcinoma, and it has certainly reference value for predicting EGFR mutation.
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