Halil KOMEK, Nadiye AKDENİZ, Zuhat URAKÇI, CANAN CAN, Serdar ALTINDAĞ

Prognostic Value of Lymph Node and Spleen Activity in [18F]FDG PET-CT in Lung Adenocarcinoma and Squamous Cell Carcinoma

Objective: We aimed to investigate the prognostic value of primary mass, spleen and lymph node metabolic activity in [18F]FDG PET-CT as well as the prognostic value of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (TLR) in patients with lung adenocarcinoma and squamous cell carcinoma. Methods: Seventy-four patients, with pathological data, complete blood count and [18F]FDG PET-CT images, were retrospectively evaluated. Patients were grouped as lung adenocarcinoma (n = 32) or squamous cell carcinoma (n = 42). The time between [18F]FDG PET-CT imaging and death was calculated. Standardized uptake value (SUVmax) of primary lesion was calculated (lung or mediastinum). The SUVmax value of the spleen was used as an indicator of RES activity. Metabolic activity of lymph node was calculated from the lymph node having the highest activity independent of localization. Results: The SUVmax spleen/liver and SUVmax lymph node/liver ratios were significantly higher in the exitus subgroup of squamous cell carcinoma (p=0.025, p=0.043; respectively). The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma (p=0.019, OR:1.282). The SUVmax spleen/liver and SUVmax lymph node/liver ratios were similar between subgroups of adenocancer. Conclusions: The SUV ratios of the spleen were not a predictor for survival in both groups. The SUVmax lymph node/liver ratio was found to be a predictor for survival in squamous cell carcinoma. However, NLR and PLR were not found to be prognostic factors.

Akciğer Adenokarsinom ve Skuamöz Hücreli Karsinomda [18F]FDG PET-BT 'de Lenf Nodu ve Dalak Aktivitesinin Prognostik Önemi

Amaç: Akciğer adenokanser ve skuamöz hücreli kanser tanısı alan hastalarda [18F]FDG PET-BT' de primer kitle, dalak ve lenf nodunun metabolik aktivitesinin prognostik değerininin yanısıra nötrofil lenfosit oranının (NLO) ve trombosit lenfosit oranının (TLO) prognostik değerlerini araştırmayı amaçladık. Yöntemler: Patolojik verilerine, tam kan sayımına ve [18F]FDG PET-BT görüntülerine ulaşılabilen 74 hasta retrospektif olarak değerlendirildi. Hastalar adenokarsinom (n = 32) veya skuamöz hücreli karsinom (n = 42) olarak gruplandırıldı. [18F]FDG PET-BT çekimi ile ölüme kadar geçen süre hesaplandı. Pimer lezyondan (akciğer veya mediasten ) standardized uptake value (SUVmax) hesaplandı. Dalağın SUVmax değeri, retiküloendotelyal sistem (RES) aktivitesinin bir göstergesi olarak kullanıldı. Lenf nodunun metabolik aktivitesi, lokalizasyondan bağımsız en yüksek aktiviteye sahip lenf nodundan hesaplandı. Bulgular: Skuamöz hücreli karsinom tanısı olup ölmüş olan grupta dalak/karaciğer SUVmax oranı ve lenf nodu/ karaciğer SUVmax oranları anlamlı derecede yüksekti (sırasıyla p = 0.025, p = 0.043) . Skuamöz hücreli karsinomda lenf nodu/karaciğer SUVmax oranının sağ kalım için belirleyici olduğu saptandı (p = 0.019, OR: 1.282). Dalak / karaciğer SUVmax ve lenf nodu / karaciğer SUVmax oranları adenokanserin alt grupları arasında benzerdi. Sonuç: Çalışmamızda dalaktaki SUV oranları her iki grupta da sağ kalım için bir belirteç değildi. Skuamöz hücreli karsinomda lenf nodu / karaciğer SUDmax oranının sağkalım için belirleyici bir faktör olduğu ancak NLO ve PLO' nun ise prognostik faktörler olmadığı görüldü.

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