Comparing PET metabolic parameters with clinicopathological factors in predicting onset of early recurrence in recently diagnosed hepatocellular carcinoma
محل انتشار: مجله پزشکی هسته ای ایران، دوره: 30، شماره: 1
سال انتشار: 1401
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 137
فایل این مقاله در 9 صفحه با فرمت PDF قابل دریافت می باشد
- صدور گواهی نمایه سازی
- من نویسنده این مقاله هستم
استخراج به نرم افزارهای پژوهشی:
شناسه ملی سند علمی:
JR_IRJNM-30-1_001
تاریخ نمایه سازی: 6 تیر 1401
چکیده مقاله:
Introduction: Early recurrence of hepatocellular carcinoma (HCC) is a major risk factor affecting survival even after hepatectomy. Many clinical, biochemical parameters and pathological grading like fibrosis ۱ index have been used for risk stratifying HCC. However not many studies have combined all of them. It is therefore important to risk stratify HCC especially with newer PET based metabolic parameters to see if they match with existing clinicopathological parameters to achieve better clinical outcome. The objectives of this study were twofold; firstly, to evaluate [۱۸F]FDG PET as a prognostic biomarker to predict tumour recurrence. Secondly, if clinicopathological parameters combined with PET indices increase the risk correlate in predicting HCC disease recurrence. Methods: Records of ۲۰۰ adult HCC patients were analysed, (۶:۱, Male: Female; mean age ± SD, ۵۲ ± ۲ year). All underwent [۱۸F]FDG PET (PET MR: PET CT = ۱۶۸:۳۲) and subsequent therapy. Patients had a follow up for at least ۱۵ months or onset of first recurrence, whichever was earlier. Clinicopathological data, alpha-fetoprotein (AFP) titres, SUVmax and few other PET indices were documented along with details of first recurrence. Statistical analysis was also performed. Results: In a multivariate analysis of various prognostic factors including T (SUVmax)/ L (SUVmax), serum alpha-fetoprotein, T stage, size of tumour, and vascular invasion of tumour, T (SUVmax)/ L (SUVmax) was the most significant with a cut off value of ۱.۹. Only vascular invasion of tumour and AFP titres had additional significance. ۱۶% ( ۳۲/۲۰۰ patients) developed recurrence (OR ۱.۶۷۳). Comparing the low and high AFP titres by Kaplan Meir curve, P was found to be ۰.۰۳۹ that predicted a worse prognosis in patients with higher AFP titres. Similarly patients with higher SUV T/L: ratio of tumour SUVmax to liver (> ۱.۹) also revealed higher recurrence rate. Cut-off SUVmax was ۳.۰۳ g/ml in our series (range ۲.۵ - ۲۳.۸ g/ml) and found to be strongly associated with AFP, tumour size, number, and histological grade of tumour. Conclusion: Our study shows that PET based metabolic indices are effective robust tools to predict tumour recurrence in aggressive HCC. Secondly, when clinicopathological parameters are combined with PET based indices there is better prediction of HCC recurrence and one can reclassify HCC patients into mild, moderate, and high-risk groups. We found it very useful in predicting poor clinical outcome especially in high-risk HCC patients; so that stricter surveillance measures can be recommended to identify early recurrence and offer appropriate therapy. The strength of this study lies in the fact that the observed associations between the combined parameters were found to be stronger than those reported in the past.
کلیدواژه ها:
نویسندگان
Shrinivas Yuvan
Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Ponekkara Post, Cochin, Kerala, India
Palaniswamy Shanmuga Sundaram
Department of Nuclear Medicine and Molecular Imaging, Amrita Institute of Medical Sciences, Ponekkara Post, Cochin, Kerala, India
Subramanyam Padma
Department of Nuclear Medicine and Molecular Imaging, Amrita Institute of Medical Sciences, Ponekkara Post, Cochin, Kerala, India
مراجع و منابع این مقاله:
لیست زیر مراجع و منابع استفاده شده در این مقاله را نمایش می دهد. این مراجع به صورت کاملا ماشینی و بر اساس هوش مصنوعی استخراج شده اند و لذا ممکن است دارای اشکالاتی باشند که به مرور زمان دقت استخراج این محتوا افزایش می یابد. مراجعی که مقالات مربوط به آنها در سیویلیکا نمایه شده و پیدا شده اند، به خود مقاله لینک شده اند :