基于<sup>18</sup>F-FDG PET/CT对广泛期小细胞肺癌预后预测模型的构建

doi:10.3969/j.issn.1006-6233.2024.07.029

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摘要 目的: 探讨广泛期小细胞肺癌预后影响因素并构建基于¹⁸F-FDG PET/CT的预后预测模型,旨在为后续临床预后预测提供更多参考。方法: 回顾性纳入2017年1月至2020年1月于我院行¹⁸F-FDG PET/CT检查广泛期小细胞肺癌患者共142例,分析临床特征资料、¹⁸F-FDG PET/CT检查指标及随访总生存情况。广泛期小细胞肺癌预后影响因素单因素和多因素分析。基于¹⁸F-FDG PET/CT对广泛期小细胞肺癌预后预测模型构建及预测效能分析。结果: 142例患者随访15~34个月,中位随访时间为24.0个月,随访过程中死亡85例,随访1年和2年总生存率分别为59.2%、34.0%。分别依据患者的年龄、骨转移情况、肝转移情况、全身MTV之和情况、全身TLG之和情况分为2个组别,各亚组的中位总生存时间比较差异有统计学意义(P<0.05)。单因素和多因素COX回归分析结果显示,年龄、是否合并骨及肝转移、全身MTV之和2.5及全身TLG之和2.5均是广泛期小细胞肺癌患者总生存时间独立影响因素(P<0.05)。基于各独立影响因素构建了患者不同时间段生存概率的列线图模型,C指数为0.763。使用ROC曲线分别计算患者1年,2年,3年生存情况预测情况,曲线下面积分别为0.631、0.718、0.722。结论: 广泛期小细胞肺癌预后除受年龄、骨转移影响外还与¹⁸F-FDG PET/CT指标关系密切;利用以上指标进行患者生存情况的预测,具有良好的效果。

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关键词 ：广泛期小细胞肺癌, 总生存时间, PET/CT, 预后

Abstract：Objective: To investigate the prognostic factors of extensive-stage small cell lung cancer (ES-SCLC) and establish a prognostic prediction model based on ¹⁸F-FDG PET/CT, to provide more references for subsequent clinical prognosis prediction. Methods: A total of 142 patients with ES-SCLC who underwent ¹⁸F-FDG PET/CT examination in our hospital from January 2017 to January 2020 were retrospectively enrolled. The clinical characteristics, ¹⁸F-FDG PET/CT examination indicators and overall survival follow-up information were analyzed. Univariate and multivariate analyses of prognostic factors for ES-SCLC were performed. Establishment and prediction performance analysis of the prognostic prediction model for ES-SCLC based on ¹⁸F-FDG PET/CT. Results: The 142 patients were followed up for 15-34 months, with a median follow-up time of 24.0 months. A total of 85 patients died during follow-up, and the 1-year and 2-year overall survival rates were 59.2% and 34.0%, respectively. According to the patients' age, bone metastasis, liver metastasis, total MTV of the whole body, and total TLG of the whole body, the patients were divided into two groups. There was a statistically significant difference in the median overall survival time between the subgroups (P<0.05). Univariate and multivariate COX regression analysis results showed that age, whether there was bone and liver metastasis, total MTV of the whole body 2.5 and total TLG of the whole body 2.5 were all independent prognostic factors for overall survival of patients with ES-SCLC (P<0.05). A line chart model of the survival probability of patients at different time periods was constructed based on each independent risk factor, and the C-index was 0.763. The ROC curve was used to calculate the prediction of the survival status of patients at 1, 2, and 3 years, respectively, and the area under the curve was 0.631, 0.718, and 0.722, respectively. Conclusion: The prognosis of ES-SCLC is closely related to ¹⁸F-FDG PET/CT indicators in addition to age and bone metastasis; using the above indicators to predict the survival status of patients has a good effect.

Key words： Extensive-stage small cell lung cancer Overall survival time PET/CT Prognosis

基金资助:陕西省重点研发计划项目,(编号:2021SF-044)

通讯作者: 范志刚

引用本文:

冯昭, 王洋, 范志刚. 基于¹⁸F-FDG PET/CT对广泛期小细胞肺癌预后预测模型的构建[J]. 河北医学, 2024, 30(7): 1210-1215.
FENG Zhao, et al. Establishment of a Prognostic Prediction Model for Extensive-Stage Small Cell Lung Cancer Based on ¹⁸F-FDG PET/CT. HeBei Med, 2024, 30(7): 1210-1215.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.07.029 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I7/1210

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