The relationship between metabolic parameters of primary focus of non-small cell lung cancers and regional lymph node metas-tasis

REN Sheng-nan; ZHANG Jian; WU Yi-yi; LIU Xiao-dong; YU Zhong-f ei; ZUO Chang-j ing

Abstract：Objective To evaluate the relationship between metabolic parameters of the original non‐small cell lung canc‐er (SUVmax ,SUVmean ,M TV ,TLG and T stage ) and regional lymph node metastasis and N stage .Methods We ret‐rospectively analyzed the 18 F‐FDG PET /CT imagines of 93 patients with non‐small cell lung cancer (NSCLC) before they had lung cancer resection and regional lymph node cleaning operation .Compared to pathology ,cases were classified into groups according to whether regional lymph node metastasis and N stage .We analyzed the differences and correlation of SUVmax ,SUVmean ,M TV ,TLG ,T stage of lung cancer primary tumor between the groups .Meanwhile ,we used ROC to analyze the value of SUVmax ,SUVmean ,M TV ,TLG ,T stage in judgment of regional lymph node metastasis in lung cancer .Results In the all 93 cases ,48 cases were N0 ,15 cases were N1 ,and 30 cases were N2 .The Mann‐Whitney U test analysis showed :SUVmax ,SUVmean ,M TV ,TLG and T stage of the original NSCLC had statistically significant differences in the two groups of whether regional lymph node metastasis ( P < 0 .05) .Spearman Correlation Analysis showed :there were correlation between SUVmax ,SUVmean ,M TV ,TLG and T stage of the original NSCLC and region‐al lymph node metastasis ( P < 0 .05) .Dependent samples nonparametric hypothesis test Kruskal‐Wallis test analysis showed :In addition to M TV ,SUVmax ,SUVmean ,TLG and T stage of the original NSCLC had statistically significant differences in N stage ( P < 0 .05) .Spearman Correlation Analysis showed :SUVmax ,SUVmean ,TLG and T stage of the original NSCLC and N stage had correlation ( P < 0 .05) ,but M TV had no correlation with N stage ( P > 0 .05) . AUC of SUVmax ,SUVmean ,M TV ,TLG ,T stage diagnosed the regional lymph node metastasis were 0 .699 ,0 .695 , 0.640 ,0 .728 ,0 .626 respectivel y( P < 0 .05) .TLG had the largest AUC in those parameters ,and had higher diagnosis efficiency .When the optimal cut off value of TLG was 13 .765(g) ,the sensitivity ,specificity ,positive predictive value , negative predictive value and accuracy of TLG to diagnose regional lymph node metastasis were 83 .7% ,45 .5% ,65 .1% , 71 .4% and 67 .7% respectively .Conclusion SUVmax ,SUVmean ,M TV ,TLG and T stage are related to regional lymph node metastasis and N stage in NSCLC ,TLG has higher diagnosis efficiency in whether regional lymph node metastasis , and it can be used as a judgment of NSCLC with regional lymph node metastasis .