摘要目的:探讨基线氟-18-氟代脱氧葡萄糖( 18F-FDG)正电子发射计算机断层扫描(PET/CT)代谢参数与晚期非小细胞肺癌(NSCLC)一线免疫检查点抑制剂(ICI)联合化疗预后的关系。 方法:回顾性分析2019至2021年于郑州大学附属肿瘤医院接受基线PET/CT检查且行一线ICI联合化疗的晚期NSCLC患者。采用受试者工作特征曲线(ROC)获得总肿瘤代谢体积(TMTV)、糖酵解总量(TLG)和最大标准摄取值(SUV max)与一线ICI联合化疗预后的最佳临界值，并收集患者外周血指标，采用Kaplan-Meier法、Log-rank法及Cox回归计算总生存(OS)及无进展生存(PFS)。 结果:共入组44例患者。单因素分析显示，TMTV>119.5 cm 3及转移灶数量>3个与较差的PFS有关( χ2＝4.19、11.28， P<0.05)；TMTV>119.5 cm 3及TLG>424.3与较差的OS有关( χ2＝14.96、6.05， P<0.05)。多因素分析显示，转移灶数量是PFS的独立预后因素( P＝0.011)，TMTV是OS的独立预后因素( P＝0.038)。 结论:在接受一线ICI治疗联合化疗的晚期NSCLC患者中，TMTV是OS的独立预后指标，转移灶数量是PFS的独立预后指标，可在临床工作中应用，但仍需前瞻性研究进一步证实。

abstractsObjective:To investigate the prognostic value of metabolic parameters of 18F-fluorodeoxyglucose ( 18F-FDG) positron emission computed tomography/computed tomography(PET/CT) in advanced non-small cell lung cancer(NSCLC) treated with first-line immune checkpoint inhibitor (ICI) combined with chemotherapy. Methods:A retrospective study was conducted to evaluate patients with advanced NSCLC who underwent baseline PET/CT before treatment at the Affiliated Cancer Hospital of Zhengzhou University from 2019 to 2021. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-offs for metabolic parameters of PET/CT, including total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and maximum standard uptake value (SUV max). Kaplan-Meier method, Log-rank test, and Cox regression model were used to calculate the overall survival (OS) and the progression-free survival(PFS). Results:A total of 44 patients were enrolled. Univariate analysis showed that the factors influencing PFS were TMTV and the number of metastatic sites ( χ2=4.19, 11.28, P<0.05) and the factors influencing OS were TMTV and TLG ( χ2=14.96, 6.05, P<0.05). Multivariate analysis suggested that number of metastatic sites was an independent prognostic marker for PFS ( P=0.011) and TMTV was an independent prognostic marker for OS ( P=0.038). Conclusions:TMTV is a prognostic indicator of OS while the number of metastatic sites is a prognostic indicator of PFS in advanced NSCLC patients who received first-line ICI combined with chemotherapy, but further prospective studies are needed.