【摘要】 目的 探讨¹⁸F-氟代脱氧葡萄糖（FDG） PET/CT参数中的最大标准化摄取值（SUVmax）、标准化摄取值峰值（SUVpeak）及肿瘤代谢体积（MTV）在预测ⅠA期肺腺癌侵袭程度中的应用价值,并分析这些代谢参数与血管内皮生长因子（VEGF）和Runt相关转录因子2（Runx2）蛋白表达的相关性。方法 回顾性分析确诊为ⅠA期肺腺癌的108例患者,术前均接受¹⁸F-FDG PET/CT检查,并通过术后病理分为微浸润组[原位腺癌（AIS）和微浸润性腺癌（MIA）,48例]和浸润组[浸润性腺癌（IAC）,60例]。提取SUVmax、SUVpeak及MTV代谢参数,采用免疫组化检测肿瘤组织中VEGF和Runx2蛋白的表达。数据通过t检验、卡方检验及Pearson相关性分析,结合Kaplan-Meier生存分析进行评估。结果 浸润组的SUVmax、SUVpeak及MTV值显著高于微浸润组（P<0.01）,其中浸润组SUVmax为5.8±1.2,SUVpeak为5.2±1.0,MTV为（32.5±5.8）cm³,微浸润组SUVmax为3.2±0.8,SUVpeak为2.9±0.7,MTV为（15.8±4.3） cm³。VEGF阳性表达率在浸润组为75%,在微浸润组为40%（P<0.01）,Runx2蛋白阳性表达率在浸润组为65%,在微浸润组为35%（P<0.05）。相关性分析显示,SUVmax与VEGF表达呈正相关（r=0.45,P<0.01）,SUVpeak与Runx2蛋白表达呈正相关（r=0.39,P<0.05）,MTV与两者均呈正相关（P<0.01,<0.05）。生存分析表明,VEGF阳性表达患者的5年生存率为60%,显著低于VEGF阴性患者的85%（P<0.05）。多元回归分析显示,SUVmax[比值比（OR）=1.8,P<0.01]和MTV（OR=2.1,P<0.01）为独立预测肺腺癌侵袭程度的风险因素。结论 SUVmax、SUVpeak及MTV在预测ⅠA期肺腺癌肿瘤侵袭程度中具有重要价值,且与VEGF和Runx2蛋白的表达密切相关。这些代谢参数可作为肺腺癌侵袭评估的关键指标,为个体化治疗提供有力支持。更多还原

【Abstract】 Objective To explore the application value of ¹⁸F-fluorodeoxyglucose（FDG） PET/CT parameters,including maximum standardized uptake value（SUVmax）,peak standardized uptake value（SUVpeak）,and metabolic tumor volume（MTV）,in predicting the invasion degree of stage Ⅰ A lung adenocarcinoma,and to analyze the correlation between these metabolic parameters and the expression of vascular endothelial growth factor（VEGF） and Runt-related transcription factor 2（Runx2） proteins.Methods A retrospective analysis was conducted on 108 patients diagnosed with stage Ⅰ A lung adenocarcinoma.All patients underwent ¹⁸F-FDG PET/CT examination before surgery and were divided into the microinvasion group [adenocarcinoma in situ（AIS） and minimally invasive adenocarcinoma（MIA）,n=48]and the invasion group [invasive adenocarcinoma（IAC）,n=60] based on postoperative pathology.The metabolic parameters of SUVm ax,SUVpeak,and MTV were extracted,and the expression of VEGF and Runx2 proteins in tumor tissues was detected using immunohistochemistry.Data were analyzed using t-test,chi-square test,and Pearson correlation analysis,combined with Kaplan-Meier survival analysis.Results The SUVmax,SUVpeak,and MTV values in the invasion group were significantly higher than those in the microinvasion group（P <0.01）,with SUVmax in the invasion group was 5.8±1.2,SUVpeak was5.2±1.0,and MTV was（32.5±5.8） cm³,while SUVmax in the microinvasion group was 3.2±0.8,SUVpeak was 2.9±0.7,and MTV was（15.8±4.3） cm³.The positive expression rate of VEGF in the invasion group was 75 %,while in the microinvasion group it was 40%（P<0.01）;the positive expression rate of Runx2 proteins in the invasion group was 65%,and in the microinvasion group it was 35%（P<0.05）.Correlation analysis showed that SUVmax was positively correlated with VEGF expression（r=0.45,P <0.01）,SUVpeak was positively correlated with Runx2 proteins expression（r=0.39,P<0.05）,and MTV was positively correlated with both（P<0.01,<0.05）.Survival analysis indicated that the 5-year survival rate of patients with positive VEGF expression was60%,significantly lower than that of negative VEGF expression patients at 85 %（P<0.05）.Multivariate regression analysis identified that SUV max[odds ratio（OR）=1.8,P<0.01] and MTV（OR=2.1,P<0.01） were independent risk factors for predicting the invasion degree of lung adenocarcinoma.Conclusion SUVmax,SUVpeak,and MTV have significant value in predicting the invasion degree of stage Ⅰ A lung adenocarcinoma and are closely related to the expression of VEGF and Runx2 proteins.These metabolic parameters can serve as key indicators for assessing lung adenocarcinoma invasion,providing strong support for individualized treatment.更多还原