目的 评估基于18F-FDG PET/CT的肿瘤代谢体积(MTV)和糖酵解总量(TLG)对Ⅱ～Ⅲ期非小细胞肺癌(NSCLC)患者的预后价值.方法 回顾性分析治疗前接受18F-FDG PET/CT检查并经病理确诊的47例Ⅱ、Ⅲ期NSCLC患者的资料.采用Kaplan-Meier法、Log-rank检验及COX比例风险模型分析代谢体积参数、总生存期(OS)和无进展生存期(PFS)的关系.MTV的测量以40％最大标准化摄取值(SUVmx)为阈值.结果 所有患者中位OS为28.93个月,中位PFS为17.37个月;1年、2年、3年整体生存率分别为80.85％(38/47)、59.57％ (28/47)、38.30％(18/47).单因素分析显示SUVmax、MTV、TLG与OS和PFS均有关系(P均＜0.05);多因素分析显示高TLG是PFS的危险因素(HR=5.591,P＜0.001),高MTV是OS的危险因素(HR=4.369,P＜0.001).MTV与TNM分期存在相关性(r=0.449,P=0.012).结论 MTV是Ⅱ、Ⅲ期NSCLC患者整体生存的独立预测因素,TLG则可预测Ⅱ、Ⅲ期NSCLC患者疾病进展.%Objective To evaluate the prognostic value of 18F-FDG PET/CT-based metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in stage Ⅱ-Ⅲ non-small cell lung cancer (NSCLC).Methods All of 47 patients with pathological stage on Ⅱ or Ⅲ NSCLC who underwent PET/CT before treatment were retrospectively reviewed.Kaplan-Meier method,Log-rank test and COX proportional hazard model were used to analyze the relationship between metabolic parameters and overall survival (OS),progression free survival (PFS).MTV were measured using a cutoff of 40％ maximum standard uptake value (SUVmax).Results The median OS and PFS was 28.93 and 17.37 months,and the 1-,2 and 3-year overall survival rate was 80.85％ (38/47),59.57％ (28/47),38.30％ (18/47),respectively.Univariate analysis suggested that SUV MTV and TLG had significant differences on OS and PFS (all P＜0.05).On multivariate analysis,TLG was a risk factor for PFS (HR=5.591,P＜0.001),and MTV was a risk factor for OS (HR=4.369,P＜0.001).MTV was correlated with TNM-staging (r=0.449,P =0.012).Conclusion In patients with stage Ⅱ or Ⅲ NSCLC,MTV is a independent significant prognostic factor for OS,and TLG is able to predict the progression.
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