CAJ | 학술논문

目的：探讨18 F-脱氧葡萄糖正电子发射计算机体层摄影（18 F-FDG PET-CT）在肝动脉化疗栓塞术（TACE）治疗原发性肝癌（HCC）患者预后判断中的价值。方法对TACE治疗前的85例HCC患者进行18 F-FDG PET 检查，并测定肝脏原发肿瘤的最大标准摄取值（ SUVmax ）。生存率用Kaplan-Meier法计算，单因素分析采用Log rank法，多因素分析采用Cox回归模型。结果高代谢组（SUVmax≥5．0）63例，低代谢组（SUVmax＜5．0）22例，低代谢组和高代谢组的肿瘤SUVmax分别为3．89±0．80和7．71±2．78，差异有统计学意义（P＜0．001）。高代谢组患者的1、2、3年生存率分别为66．6％、26．9％和12．6％，低代谢组患者的1、2、3年生存率分别为81．8％、72．7％和63．6％，高代谢组和低代谢组患者的中位生存时间分别为16．0个月和48．0个月（ P＜0．001）。单因素分析显示，肝内原发肿瘤SUVmax、有无肝硬化、Child分级、ECOG评分、肿瘤大小、肿瘤数目、有无门脉癌栓、BCLC分期和血清甲胎蛋白（ AFP）水平与HCC患者的预后有关（均P＜0．05）。 Cox多元回归分析显示，肿瘤SUVmax值、肿瘤大小、肿瘤数目和血清AFP水平是影响HCC患者预后的独立因素（均P＜0．05）。结论肝内原发肿瘤SUVmax可以作为判断TACE治疗HCC患者的预后因素。
목적：탐토18 F-탈양포도당정전자발사계산궤체층섭영（18 F-FDG PET-CT）재간동맥화료전새술（TACE）치료원발성간암（HCC）환자예후판단중적개치。방법대TACE치료전적85례HCC환자진행18 F-FDG PET 검사，병측정간장원발종류적최대표준섭취치（ SUVmax ）。생존솔용Kaplan-Meier법계산，단인소분석채용Log rank법，다인소분석채용Cox회귀모형。결과고대사조（SUVmax≥5．0）63례，저대사조（SUVmax＜5．0）22례，저대사조화고대사조적종류SUVmax분별위3．89±0．80화7．71±2．78，차이유통계학의의（P＜0．001）。고대사조환자적1、2、3년생존솔분별위66．6％、26．9％화12．6％，저대사조환자적1、2、3년생존솔분별위81．8％、72．7％화63．6％，고대사조화저대사조환자적중위생존시간분별위16．0개월화48．0개월（ P＜0．001）。단인소분석현시，간내원발종류SUVmax、유무간경화、Child분급、ECOG평분、종류대소、종류수목、유무문맥암전、BCLC분기화혈청갑태단백（ AFP）수평여HCC환자적예후유관（균P＜0．05）。 Cox다원회귀분석현시，종류SUVmax치、종류대소、종류수목화혈청AFP수평시영향HCC환자예후적독립인소（균P＜0．05）。결론간내원발종류SUVmax가이작위판단TACE치료HCC환자적예후인소。
Objective To evaluate the prognostic significance of 18 F-FDG PET-CT SUVmax value in 85 patients with hepatocellular carcinoma ( HCC ) before transarterial chemoembolization ( TACE ) . Methods A retrospective analysis was conducted on 85 patients with HCC before TACE to evaluate the prognostic significance of SUVmax of 18 F-FDG PET-CT.The survival rates were calculated using Kaplan-Meier method.Log-rank method was used for univariate analysis , and Cox regression model was used for multivariate analysis .Results The patients were divided into two groups before TACE:The high metabolic group (63 patients, with SUVmax value 7.71 ±2.78) and low metabolic group (22 patients, with SUVmax value 3.89 ±0.80).The SUVmax levels were statistically different ( P<0.001).The 1-, 2-and 3-year survival rates of the 63 patients of high metabolic group were 66.6%, 26.9% and 12.6%, respectively. The 1-, 2-and 3-year survival rates of the 22 patients of low metabolic group were 81.8%、72.7% and 63.6%, respectively.The median survival time of the high metabolic group was 16.0 months and that of the low metabolic group was 48.0 months (P=0.001).Univariate analysis indicated that SUVmax value of the intrahepatic primary tumor, hepatic cirrhosis, Child-Pugh score, ECOG score, intrahepatic tumor size, number of tumors(solitary or multiple), portal vein tumor thrombus,BCLC stage, and serum AFP level were significantly correlated with prognosis of the patients (P<0.05 for all).Multivariate analysis indicated that SUVmax value , tumor size >8 cm, number of tumors ( solitary or multiple ) and AFP level were independent prognostic factors ( P <0.05 for all ).Conclusion The SUVmax value of the primary intrahepatic tumor can be used as an important prognostic factor to predict the effect of TACE in patients with hepatocellular carcinoma .