小细胞肺癌原发灶18F-FDG PET CT代谢参数与外周血炎症标记物的相关性研究
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1.南京医科大学附属肿瘤医院,江苏省肿瘤医院,江苏省肿瘤防治研究所;2.南京医科大学第一附属医院

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江苏省卫生计生委面上课题(H2018029),江苏省肿瘤医院院基金项目(No.ZJ202122)


Association of PET CT metabolic parameters with inflammatory markers in peripheral blood of patients with small cell lung cancer
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1.the Affiliated Cancer Hospital of Nanjing Medical University and Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research;2.the First Affiliated Hospital of Nanjing Medical University

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National Jiangsu Provincial Health and Family Planning Commission Foundation (H2018029), Research Project of Jiangsu Cancer Hospital (No. ZJ202122)

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    摘要:

    目的:评估小细胞肺癌患者原发灶18F-FDG PET/CT代谢参数[最大标准摄取值(maximum standardized uptake value, SUVmax)、平均标准摄取值(mean standardized uptake value, SUVmean)、肿瘤代谢体积(metabolic tumor volume, MTV)和病灶糖酵解总量 (total lesion glycolysis,TLG)]与外周血炎症标志物中性粒细胞与淋巴细胞比值(neutrophil / lymphocyte ratio, NLR)、血小板与淋巴细胞比值(platelet / lymphocyte ratio, PLR)、单核细胞与淋巴细胞比值(monocyte / lymphocyte ratio, MLR)及全身免疫炎症指数(systemic immune-inflammation index,SII)之间的相关性。方法:回顾性分析2014—2019年于南京医科大学第一附属医院核医学科行PET/CT检测且未行任何治疗的小细胞肺癌患者,收集PET/CT检查前1周内的血清炎症标志物(单核细胞、中性粒细胞、淋巴细胞、血小板)、临床资料及原发灶PET/CT代谢参数数据,通过Spearman检验分析它们之间的相关性。结果:56例小细胞患者的血清炎症标志物NLR、PLR、MLR、SII与原发灶PET/CT部分代谢参数[TLG (rNLR=0.309, rPLR=0.304,rMLR=0.271,rSII=0.362), MTV (rNLR=0.354, rPLR=0.341,rMLR=0.290, rSII=0.411)]之间存在轻度正相关性(均P<0.05),而均与原发灶的SUVmax及SUVmean均无显著相关性(P均>0.05)。广泛期小细胞肺癌患者NLR、MLR、SII、中性粒细胞及原发灶PET/CT部分代谢参数(MTV、TLG)的水平高于局限期,广泛期淋巴细胞低于局限期(均P<0.05),而SUVmax、SUVmean、PLR、单核细胞及血小板在小细胞癌局限期和广泛期之间无统计学差异(均P>0.05)。结论:小细胞肺癌基线期的炎症标记物可能不仅反映全身炎症情况,而且反映肿瘤病灶以18F-FDG活性为代表的炎症情况。对于NLR、MLR或SII增高的小细胞肺癌患者而言,可能有必要通过PET/CT检查进行分期,从而调整后续的治疗方案。

    Abstract:

    Objective: This study was aimed to evaluate the correlation between inflammatory markers [neutrophil / lymphocyte ratio (NLR), platelet / lymphocyte ratio (PLR), monocyte / lymphocyte ratio (MLR) and systemic immune-inflammation index (SII)] and 18F-fluorodeoxyglucose (FDG) positron emission tomography / computed tomography (PET/CT) metabolic parameters [maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), TLG (total lesion glycolysis)] in patients with small cell lung cancer (SCLC) at baseline. Methods: A total of 56 patients who undergone 18F-FDG PET/CT and did not receive any treatment in Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University between 2014 and 2019 were analyzed retrospectively. The metabolic parameters of primary tumor, clinical data and inflammatory markers (neutrophil count, monocyte count, lymphocyte count, platelet count) within one week before PET/CT detection were collected to analyze the correlation by Spearman’s rho test. Results: The slight positive correlations were found between inflammatory markers (NLR, PLR, MLR, SII) and partial metabolic parameters [TLG (rNLR=0.309, rPLR=0.304, rMLR=0.271, rSII=0.362), MTV (rNLR=0.354, rPLR=0.341, rMLR=0.290, rSII=0.411)] of primary tumor in 56 patients with SCLC (all P<0.05). The SUVmax and SUVmean were not found the correlation with these hematological parameters (all P>0.05). The NLR, MLR, SII, neutrophils, MTV and TLG in extended stage were higher than those in limited stage, and the lymphocytes in extended stage were lower than those in limited stage(all P<0.05), but SUVmax, SUVmean, PLR, monocytes and platelets were not found differences in extended and limited stage(all P>0.05). Conclusion: Baseline inflammatory markers of SCLC not only reflect the systemic metabolism, but also reflect the local inflammation of tumor. And it might be necessity to undergoing Whole-body PET/CT for staging and adjusting treatment strategy in those patients with high NLR, MLR or SII.

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  • 收稿日期:2022-05-31
  • 最后修改日期:2023-01-28
  • 录用日期:2023-04-17
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