Abstract：
OBJECTIVE: The mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax) on fluorine-18 fluorodeoxyglucose-positron emission tomography are prognostic biomarkers for survival and nodal involvement in non-small-cell lung cancer but their prognostic value in lung neuroendocrine neoplasms (NENs) remains unexplored. In this study, we aimed to examine whether they are also prognostic biomarkers for survival and nodal involvement in lung NENs.
METHODS: We retrospectively studied patients with typical carcinoid, atypical carcinoid or large cell neuroendocrine carcinoma who had been radically resected at our institution between 2008 and 2020. We measured SUVmean and SUVmax on all primary tumours and lymph nodes that were clinically and/or pathologically involved. We dichotomized the patients into groups of high or low SUVmean and SUVmax of the primary tumour using time-dependent receiver operating characteristic curves and compared their overall survival using Kaplan-Meier curves and Cox models. Lastly, we predicted the patients\' pathological nodal status with SUVmean and SUVmax of the lymph nodes using binomial logistic models.
RESULTS: The study included 245 patients. Patients died earlier if their SUVmean of the primary tumour exceeded 3.9 [hazard ratio 1.97, 95% confidence interval (CI) 1.27-3.04, P = 0.002] or SUVmax exceeded 5.3 (hazard ratio 1.85, 95% CI 1.20-2.87, P = 0.006). Likewise, patients had a higher risk of pathological nodal involvement if their SUVmean of the lymph nodes exceeded 3.3 (odds ratio 10.00, 95% CI 2.59-51.01, P = 0.002) or SUVmax exceeded 4.2 (odds ratio 4.00, 95% CI 1.20-14.65, P = 0.028).
CONCLUSIONS: The fluorine-18 fluorodeoxyglucose-positron emission tomography SUVmean and SUVmax are strong prognostic biomarkers for survival and nodal involvement in lung NENs and could be important guides for making treatment decisions.
METHODS: We retrospectively studied patients with typical carcinoid, atypical carcinoid or large cell neuroendocrine carcinoma who had been radically resected at our institution between 2008 and 2020. We measured SUVmean and SUVmax on all primary tumours and lymph nodes that were clinically and/or pathologically involved. We dichotomized the patients into groups of high or low SUVmean and SUVmax of the primary tumour using time-dependent receiver operating characteristic curves and compared their overall survival using Kaplan-Meier curves and Cox models. Lastly, we predicted the patients\' pathological nodal status with SUVmean and SUVmax of the lymph nodes using binomial logistic models.
RESULTS: The study included 245 patients. Patients died earlier if their SUVmean of the primary tumour exceeded 3.9 [hazard ratio 1.97, 95% confidence interval (CI) 1.27-3.04, P = 0.002] or SUVmax exceeded 5.3 (hazard ratio 1.85, 95% CI 1.20-2.87, P = 0.006). Likewise, patients had a higher risk of pathological nodal involvement if their SUVmean of the lymph nodes exceeded 3.3 (odds ratio 10.00, 95% CI 2.59-51.01, P = 0.002) or SUVmax exceeded 4.2 (odds ratio 4.00, 95% CI 1.20-14.65, P = 0.028).
CONCLUSIONS: The fluorine-18 fluorodeoxyglucose-positron emission tomography SUVmean and SUVmax are strong prognostic biomarkers for survival and nodal involvement in lung NENs and could be important guides for making treatment decisions.
摘要：
目的：氟-18氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）的平均和最大标准化摄取值（SUVmean和SUVmax）是非小细胞肺癌生存和淋巴结受累的预后生物标志物，但其在肺神经内分泌肿瘤（NEN）中的预后价值仍未被研究。在这项研究中,我们旨在研究它们是否也是肺NENs生存和淋巴结受累的预后生物标志物.
方法：我们回顾性研究了典型类癌患者，非典型类癌，或在2008年至2020年间在我们机构彻底切除的大细胞神经内分泌癌。我们测量了临床和/或病理涉及的所有原发性肿瘤和淋巴结的SUVmean和SUVmax。我们使用时间依赖性受试者工作特征曲线将患者分为原发性肿瘤的SUV均值和SUVmax高或低的组，并使用Kaplan-Meier曲线和Cox模型比较了他们的总体生存率。最后,我们使用二项逻辑模型预测患者的淋巴结SUVmean和SUVmax的病理淋巴结状态。
结果：该研究包括245名患者。如果原发肿瘤的SUV均值超过3.9（HR1.97，95％CI1.27-3.04，p=0.002）或SUVmax超过5.3（HR1.85，95％CI1.20-2.87，p=0.006），则患者死亡较早。同样，如果患者的淋巴结SUV均值超过3.3(OR10.00,95%CI2.59-51.01,p=0.002)或SUVmax超过4.2(OR4.00,95%CI1.20-14.65,p=0.028),则患者出现病理性淋巴结受累的风险较高.
结论：FDG-PETSUVmean和SUVmax是肺NENs生存和淋巴结受累的强预后生物标志物，可能是制定治疗决策的重要指南。
方法：我们回顾性研究了典型类癌患者，非典型类癌，或在2008年至2020年间在我们机构彻底切除的大细胞神经内分泌癌。我们测量了临床和/或病理涉及的所有原发性肿瘤和淋巴结的SUVmean和SUVmax。我们使用时间依赖性受试者工作特征曲线将患者分为原发性肿瘤的SUV均值和SUVmax高或低的组，并使用Kaplan-Meier曲线和Cox模型比较了他们的总体生存率。最后,我们使用二项逻辑模型预测患者的淋巴结SUVmean和SUVmax的病理淋巴结状态。
结果：该研究包括245名患者。如果原发肿瘤的SUV均值超过3.9（HR1.97，95％CI1.27-3.04，p=0.002）或SUVmax超过5.3（HR1.85，95％CI1.20-2.87，p=0.006），则患者死亡较早。同样，如果患者的淋巴结SUV均值超过3.3(OR10.00,95%CI2.59-51.01,p=0.002)或SUVmax超过4.2(OR4.00,95%CI1.20-14.65,p=0.028),则患者出现病理性淋巴结受累的风险较高.
结论：FDG-PETSUVmean和SUVmax是肺NENs生存和淋巴结受累的强预后生物标志物，可能是制定治疗决策的重要指南。
