摘要目的 评估18F-氟代脱氧葡萄糖正电子发射计算机断层显像(18F-FDG PET)/CT在食管鳞癌初始诊治中对远期生存的预测价值.方法 回顾性分析2010年1月至2014年12月北京大学肿瘤医院胸外一科食管癌前瞻性数据库手术病例,根据入组及排除标准共167例纳入研究,比较原发肿瘤治疗前PET/CT最大标准摄取值(SUVmax)与患者年龄、性别、肿瘤位置、肿瘤分化程度、脉管癌栓、肿瘤退缩分级及远期预后的关系.结果 本组167例食管鳞癌患者中位随访时间46.9(30.5 ～86.2)个月,术后1、3年生存率分别为95.1％和68.4％.肿瘤SUVmax与肿瘤的cT(P＜0.01)、cN(P =0.033)、cTNM(P =0.002)及pTNM(P =0.003)正相关.原发肿瘤SUVmax≤6者预后好于SUVmax＞6者,两者3年总生存分别为83.4％和65.6％ (P =0.02),3年无疾病生存分别为82.4％和55.4％ (P =0.006).全组多因素回归分析结果显示,肿瘤治疗前SUVmax＞6是食管鳞癌患者总生存(HR=3,95％CI1.050～ 8.568)及无疾病生存(HR=3.971,95％ CI 1.408 ～ 11.200)的独立预后因素.结论 食管鳞癌原发肿瘤的初始18F-FDG PET/CT SUVmax越高,远期生存越差,可将其作为治疗前判断远期预后的指标.

abstractsObjective To evaluate the value of 1s F-FDG PET/CT in predicting long-term survival of esophageal squamous cell carcinoma (ESCC) before initial treatment.Methods A total of 167 ESCC patients were retrospectively analyzed who underwent surgery between January 2010 and December 2014 in prospective database of Peking University Cancer Hospital Thoracic Surgery Department One,all cases were included according to inclusion and exclusion criteria.The relationship between SUVmax of the primary tumor and patients' age,gender,tumor location,tumor differentiation,tumor regression grade as well as long term survival were compared.Results The median follow-up time of the 167 cases was 46.9 months (ranging from 30.5 to 86.2 months),with 1 year and 3 years postoperatively being 95.1％ and 68.4％,respectively.The SUVmax of the tumor was positively correlated with cT (P ＜ 0.01),cN (P =0.033),cTNM(P =0.002) and pTNM (P =0.003)of the tumor.Patients with SUVmax ≤6 obtained a survival significantly better compared with patients with SUVmax ＞ 6,the 3 years OS were 83.4 ％ vs 65.6％ (P =0.02),and DFS were 82.4％ vs 55.4％ (P =0.006),respectively.The multivariate regression analysis demonstrated that the SUVmax ＞ 6 before treatment was the independent prognostic factor for OS (HR =3,95％CI 1.050-8.568) and DFS (HR =3.971,95％ CI 1.408-11.200) of the ESCC patients.Conclusions The higher the 18F-FDG PET/CT SUVmax of the ESCC primary tumor,the poorer survival of the patients.Therefore,SUVmax could be used as an indicator to predict long term survival of the ESCC patients before treatment.