Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. 18F-FDG PET/CT scans were performed and different SUV parameters (SUVmax, SUVavg, SUVT/L, and SUVT/A) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUVmax, SUVavg, and SUVT/L of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUVT/L was the primary predictor for tumor differentiation. However, in adenocarcinoma, SUVmax was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUVT/L appeared to be most useful overall, but SUVmax was the best index for adenocarcinoma tumor differentiation.

18F-氟代脱氧葡萄糖（18F-fluoro-2-deoxyglucose, FDG）正电子发射断层扫描（positron emission tomography, PET）/计算机断层扫描（computed tomography, CT）被广泛应用于非小细胞肺癌（non-small cell lung cancer, NSCLC）的诊断与分期。本回顾性研究旨在评估不同FDG标准化摄取值（standardized uptake values, SUVs）对74例初诊非小细胞肺癌患者的预测价值。研究对所有受试者行18F-FDG PET/CT扫描，获取多项SUV参数（包括SUVmax、SUVavg、SUVT/L及SUVT/A），并分析其与临床特征的相关性。同时通过相关性分析及多元逐步回归分析，明确非小细胞肺癌患者SUVs的主要预测因子。结果显示，年龄、性别及肿瘤大小对SUV参数存在显著影响；鳞状细胞癌的平均SUV值高于腺癌；低分化肿瘤的SUV值高于高分化肿瘤。进一步基于病理类型的亚组分析表明，低分化腺癌的SUVmax、SUVavg及SUVT/L均高于中分化或高分化腺癌。在上述四项SUV参数中，SUVT/L是肿瘤分化程度的整体最佳预测因子；但在腺癌亚组中，SUVmax才是决定肿瘤分化程度的关键指标。本研究结果证实，四项SUV参数均与非小细胞肺癌的肿瘤分化程度存在预测相关性；整体而言SUVT/L的应用价值最为突出，而针对腺癌患者的肿瘤分化程度评估，SUVmax则是最优指标。