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간세포암종 환자의 예후 예측에 있어 양전자방출단층촬영(PET)의 유용성

Positron Emission Tomography with Fluorine-18-Fluorodeoxyglucose is Useful for Predicting the Prognosis of Patients with Hepatocellular Carcinoma

김유철|김진|이진오|최창운|천기정|임상무|정숙향|한철주|이상대|김민재|공윤호|손위식|기승석
대한간학회 (The korean Association for the Study of the Liver)|2004.12|Clinical and Molecular Hepatology|제10권 제2004호|pp. 279-287

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참고문헌

키워드

양전자방출단층촬영Hepatocellular carcinomaPrognosis예후간세포암종Positron emission tomography

초록

목적: 간세포암종은 FDG-PET 영상에서 다양한 수준의 FDG 축적을 보인다. 이는 간세포암종의 포도당 대사 활성이 다양함을 의미하는데, 이러한 차이가 환자의 예후와 연관이 있는지를 알아보고자 하였다. 대상과 방법: 27예의 간세포암종 환자들을 대상으로 각각의 환자에서 FDG-PET 영상을 얻어 FDG 축적의 정도(SUV 및 SUV비)를 조사하였고 이들 변수들이 생존율에 영향을 줄 수 있는 인자인지를 확인하기 위해 Cox proportional hazard model로 회귀분석을 시행하였다. 생존율은 Kaplan-Meier법으로 계산하였고 생존율의 차이는 Wilcoxon test로 검증하였다. 결과: 1년 누적생존율은 37%, 3년 누적생존율은 11%였다. 조사된 생존율 관련 인자들 중 통계적 유의성을 보였던 지표는 SUV뿐이었으며(P=0.001), SUV비는 통계적 유의성을 보이지 않았다. SUV가 7 미만인 군과 7 이상인 군에서 생존기간의 중간치는 각각 15개월과 4개월로서 SUV가 높은 군, 즉 종양의 포도당 대사가 항진되어 있는 환자군에서 통계적으로 의미 있게 짧은 생존 기간을 보였다(P=0.003). 결론: 간세포암종 환자의 FDG-PET 영상에서 측정된 SUV는 중요한 예후 예측 지표이며 높은 SUV는 불량한 예후를 시사한다.

Abstract

Background/Aims: Hepatocellular carcinoma (HCC) is heterogenous in terms of its glucose metabolism. Positron emission tomography with fluorine-18-fluorodeoxyglucose (FDG-PET) shows various levels of FDG uptake for patients with HCC. This study was designed to assess the usefulness of FDG-PET for predicting the outcome of the patients with HCC. Methods: FDG-PET was performed for 27 patients with HCC. The standardized uptake value (SUV) and SUV ratio (defined as the tumor-to-nontumor ratio of SUV) was calculated for each patient. The clinical factors of the outcome were analyzed by regression analysis using Cox’s multivariate proportional hazard model. The survival rate was calculated by the Kaplan-Meier method. Results: Among the analyzed clinical factors including tumor size, number of tumors, AFP, involvement of major vessels, presence of systemic metastases, Child-Pugh class the SUV and SUV ratio, only the SUV was the only significant independent prognostic factor (p=0.001). On the basis of the SUV, the patients were divided into two groups of roughly equal size: group A, SUV of <7; group B, SUV >7. The cumulative survival rate was significantly lower for group B than for group A, and the median survival time was significantly different (4 months vs 15 months, respectively) (p=0.003). Conclusions: These results suggest that FDG-PET is useful to predict the outcome for patients with hepatocellular carcinoma.

참고문헌 (48)

  1. "Elevated levels of glucose transport and transporter messenger RNA are induced by ras or src oncogenes", 235, pp.1492~1495 (1987)
  2. "Physicochemical properties and isoenzyme composition of hexokinase from normal and malignant human tissues", 61, pp.27~34 (1978)
  3. "differentiation and growth rates of transplanted rat tumors", pp.2240~2244
  4. "Staging of mediastinal non-small cell lung cancer with FDG PET", pp.371~377
  5. "Positron emission tomography to stage suspected metastatic colorectal carcinoma to the liver", 171, pp.21~26 (1996)
  6. "Positron emission tomography with F-18-fluorodeoxyglucose to evaluate the results of hepatic chemoembolization", 78, pp.2216~2222 (1996)
  7. "Glucose-6-phosphatase activity in normal", pp.105~108
  8. "Comparative biochemistry of hepatomas carbohydrate enzymes in liver tumors of different growth rates", pp.987~994
  9. "Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET:characterization of tumor and assessment of effect of treatment", 33, pp.333~339 (1992)
  10. "In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET", 36, pp.1811~1817 (1995)
  11. "Quantification of glucose utilization in liver metastases parametric imaging of FDG uptake with PET", pp.684~689
  12. "각종 간 병변에 대한 양전자 방출 단층촬영(PET)영상 소견 분석", 8, pp.472~480 (2002)
  13. "Fluorine-18- FDG positron emission tomography for imaging of hepatocellular carcinoma", 94, pp.3314~3319 (1999)
  14. "Evaluation of benign vs malignant hepatic lesions with positron emission tomography", 133, pp.510~515 (1998)
  15. "Usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose for predicting outcome in patients with hepatocellular carcinoma", 96, pp.1877~1880 (2001)
  16. "Dose-response relationship between probability of pathologic tumor control and glucose metabolic rate measured with FDG PET after preoperative chemoradiotherapy in locally advanced non-small-cell lung cancer", 54, pp.1024~1035 (2002)
  17. "From tumor biology to clinical Pet: a review of positron emission tomography (PET) in oncology.", 15, pp.471~486 (2001)
  18. "18-Fluorodeoxyglucose positron emission tomography in predicting survival of patients with pancreatic carcinoma", 7, pp.953~959 (2003)
  19. "Overexpression of Glut-1 and increased glucose metabolism in tumors are associated with a poor prognosis in patients with oral squamous cell carcinoma", 97, pp.1015~1024 (2003)
  20. "Prognostic significance of (18)F-FDG and (99m)Tc-methylene diphosphonate uptake in primary osteosarcoma", 43, pp.1012~1017 (2002)
  21. "The glycolytic phenotype in carcinogenesis and tumor invasion:insights through mathematical models", 63, pp.3847~3854 (2003)
  22. "On the metabolism of tumors in the body The metabolism of tumors", pp.254~270 (1930)
  23. -fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary, , 2004, 926~932
  24. fluorodeoxyglucose and positron emission tomography, , 1982, 1323~1329
  25. "Glucose depletion enhances P-glycoprotein expression in hepatoma cells:role of endoplasmic reticulum stress response", 63, pp.7284~7290 (2003)
  26. "Glucose transporters: expression, regulation and cancer", 35, pp.9~26 (2002)
  27. "Natural history of hepatocellular carcinoma and prognosis in relation to treatment Study of 850 patients", pp.918~928
  28. "Prospective validation of the CLIP score:a new prognostic system for patients with cirrhosis and hepatocellular carcinoma", 32, pp.679~680 (2000)
  29. "Prognosis of hepatocellular carcinoma:the BCLC staging classification", 19, pp.329~338 (1999)
  30. "Predictive factors for long term prognosis after partial hepatectomy for patients with hepatocellular carcinoma in Japan", 74, pp.2772~2780 (1994)
  31. "Prognostic staging system for hepatocellular carcinoma (CLIP score): its value and limitations, and a proposal for a new staging system, thre Japan Integrated Staging Score (JIS score)", 38, pp.207~215 (2003)
  32. "Construction of the Chinese University Prognostic Index for hepatocellular carcinoma and comparison with the TNM staging system, the Okuda staging system, and the Cancer of the Liver Italian Program staging system: a study based on 926 patients", 94, pp.1760~1769 (2002)
  33. "Predictable factors for estimating prognosis of patients after resection of hepatocellular carcinoma", 72, pp.1178~1183 (1993)
  34. "Prognosis of hepatocellular carcinoma associated with Child class B and C cirrhosis in relation to treatment:a multivariate analysis of 411 patients at a single center", 9, pp.469~477 (2002)
  35. "Factors affecting long-term outcome after hepatic resection for hepatocellular carcinoma", 169, pp.28~34 (1995)
  36. "Clinical significance of microscopic tumor venous invasion in patients with resectable hepatocellular carcinoma", 127, pp.603~608 (2000)
  37. "Prognostic factors for hepatocellular carcinoma < or =3 cm in diameter", 50, pp.2043~2048 (2003)
  38. "Simplified staging for hepatocellular carcinoma", 20, pp.1527~1536 (2002)
  39. "Prognostic value of serum biological markers in patients with hepatocellular carcinoma", 7, pp.3504~3509 (2001)
  40. "The role of telomerase activity in hepatocellular carcinoma", 95, pp.748~752 (2000)
  41. "The status of Fas and Fas ligand expression can predict recurrence of hepatocellular carcinoma", 82, pp.1211~1217 (2000)
  42. "Relationship between loss of heterozygosity at microsatellite loci and computerized nuclear morphometry in hepatocellular carcinoma", 20, pp.1257~1262 (2000)
  43. "Beta-catenin mutations are associated with a subset of low-stage hepatocellular carcinoma negative for hepatitis B virus and with favorable prognosis", 157, pp.763~770 (2000)
  44. "Molecular cytogenetic evaluation of virus-associated and non-viral hepatocellular carcinoma:analysis of 26 carcinomas and 12 concurrent dysplasias", 192, pp.207~215 (2000)
  45. "Genes and viruses in hepatobiliary neoplasia", 19, pp.84~93 (2000)
  46. "Assessment of the biological malignancy of hepatocellular carcinoma:relationship to clinicopathological factors and prognosis", 4, pp.1475~1482 (1998)
  47. "Prognostic significance of pathological and biological factors in hepatocellular carcinoma", 13, pp.666~670 (1998)
  48. "From tumor biology to clinical Pet a review of positron emission tomography (PET) in oncology", 15, pp.471~486 (2001)

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