在采用PET/CT分期的T1-2N0M0 NSCLC患者中预测隐匿性淋巴结转移的危险因素：在医院中的潜在价值

Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China

Background and objective: The aims of our study were to evaluate the occult nodal metastasis in clinical stage I patients by PET/CT, further investigate the potential risk factors for nodal involvement, since a successful prediction could be helpful in selection appropriate candidates for SABR or limited surgery. Methods: We retrospectively reviewed the records of 189 patients who diagnosed as clinical stage I NSCLC by ¹⁸F-FDG PET/CT from January 2004 to July 2011. All patients underwent lobectomy and systematic lymph node dissection and preoperative ¹⁸F-FDG PET/CT scanning. The prevalence of occult nodal metastasis in patients as clinical N₀ was analyzed according to clinicopathological factors such as tumor location, tumor size, tumor subtype, grade of differentiation and primary tumor SUV_max. Risk factors for occult nodal metastasis were defined by univariate and multivariate analysis. Results: Occult nodal metastasis was detected in 18.0% (34/189) of the patients. SUV_max of the primary tumor and tumor size were independent predictors of occult nodal metastasis for patients with clinical N₀ NSCLC by FDG PET/CT. Accordingly we divided our patients into three groups: group 1 (low-risk group) ~T≤3cm and SUV_max≤4.3; group 2 (moderate-risk group) ~T≤3cm and SUV_max>4.3 or SUV_max≤4.3 and T>3cm; group 3 (high-risk group) ~T>3cm and SUV_max>4.3. The occult lymph node metastasis rate in groups 1, 2, 3 was 1/82 (1.2%), 19/75 (25.3%) and 14/32 (43%) respectively. Conclusions: T_1-2N₀M₀ NSCLC patients by PET/CT showing larger tumor size and high SUV_max constitute a high-risk group for occult nodal metastasis. The combined information of primary tumor SUV_max and tumor size before treatment have potential values in the clinic. These findings would be helpful in selection of SABR or limited surgery candidates. © 2013.

Fu, X.; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China;