摘要
目的探讨^(18)F-FDG PET/CT征象及Ki-67表达与肺腺癌表皮生长因子受体(epidermal growth factor receptor,EGFR)突变的相关性。方法回顾分析95例经病理证实肺腺癌患者的^(18)F-FDG PET/CT征象、EGFR突变检测结果、Ki-67表达及一般临床资料。分析PET/CT征象(包括毛刺征、分叶征、胸膜牵拉征、血管集束征、空泡征、支气管截断征、SUVmax)、Ki-67表达、性别、年龄、吸烟史与EGFR突变状态的相关性。采用受试者工作特征(receiver operating characteristic,ROC)曲线计算最大标准摄取值(SUVmax)的截断值,Logistic回归分析影响EGFR突变的预测因素。结果EGFR突变患者的SUVmax值明显低于野生型患者(t=2.813,P=0.006),21号外显子突变患者的SUVmax低于野生型患者(t=3.274,P=0.002),野生型患者与19号外显子突变患者的SUV m a x差异无统计学意义(t=1.323,P=0.193),两种不同类型突变型SUVmax差异无统计学意义(t=-1.579,P=0.124)。ROC曲线分析显示,SUVmax预测EGFR突变的截断值为6.36。EGFR突变患者的Ki-67与野生型相比更易发生低表达(χ^(2)=4.867,P=0.027),21号外显子突变型患者Ki-67表达与野生型差异有统计学意义(χ^(2)=5.576,P=0.018),19号外显子突变型与野生型Ki-67表达差异无统计学意义(χ^(2)=0.328,P=0.567),两种不同类型突变型Ki-67表达差异无统计学意义(χ^(2)=1.791,P=0.181)。单因素分析结果显示,性别、吸烟、分叶征、血管集束征及SUVmax与EGFR突变有关(P<0.05),而年龄、毛刺征、胸膜牵拉征、空泡及支气管截断征与EGFR突变无关(P>0.05)。根据Logistic多因素分析的结果,性别、血管集束征和SUVmax是预测EGFR突变的独立因素(P<0.05)。结论SUVmax是预测肺腺癌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 explore the correlation of^(18)F-FDG PET/CT signs and Ki-67 expression with epidermal growth factor receptor(EGFR)mutation in lung adenocarcinoma.Methods We retrospectively analyzed the^(18)F-FDG PET/CT data,immunohistochemical,the expression of Ki-67 and general clinical data of 95 patients with pathologically confirmed lung adenocarcinoma.To analyze the differences of PET/CT manifestations,the expression of Ki-67,gender,age,smoking status for EGFR mutation status.Receiver operating characteristic(ROC)curve was used to test the cult-off of maxium standard uptake(SUVmax).Logistic regression model was employed to analyze the independent predictive factors for EGFR.Results Patients with EGFR mutations had significantly lower SUVmax than wild-type EGFR patients(t=2.813,P=0.006).Further analysis found that patients with type Exon 21 of EGFR mutation had lower SUVmax than wild-type patients(t=3.274,P=0.002),but there was no statistical difference in SUVmax between type Exon 19 of EGFR mutation and wild type patients(t=1.323,P=0.193),There was no statistically significant difference between the two different types of mutant SUVmax(t=-1.579,P=0.124).ROC curve showed that the cut-off of SUVmax was 6.36.The low expression rate of Ki-67 was more common in EGFR mutant patients than in wild-type patients(χ^(2)=4.867,P=0.027),There was a statistically significant difference in the expression of Ki-67 between the exon 21 mutant and the wild type(χ^(2)=5.576,P=0.018);there was no significant difference in the expression of Ki-67 between the exon 19 mutant and wild type(χ^(2)=0.328,P=0.567).the expression of two different types of mutant Ki-67 was not statistically significant(χ^(2)=1.791,P=0.181).Univariate analysis showed that gender,smoking,lobulation sign,vessel convergence sign and SUVmax were all associated with EGFR mutation(P<0.05),age,spiculation sign,pleural indentation sign,vacuole sign,and bronchial truncation sign are not related to EGFR mutation(P>0.05).Logistic multivariate analysis showed that smoking status and SUVmax were the independent factors for predicting EFGR(P<0.05).Conclusion SUVmax of^(18)F-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.
作者
郭丽娟
张会杰
段慧玲
李凤娟
孙凤霞
GUO Li-juan;ZHANG Hui-jie;DUAN Hui-ling;LI Feng-juan;SUN Feng-xia(Department of Nuclear Medicine,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China;Department of Imaging,Xinxiang Central Hospital,Xinxiang 453000,Henan Province,China)
出处
《中国CT和MRI杂志》
2024年第8期35-38,共4页
Chinese Journal of CT and MRI
