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. 2015 Aug;20(8):926-33.
doi: 10.1634/theoncologist.2014-0356. Epub 2015 Jun 22.

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Kyoung-Min Cho  1 , Do-Youn Oh  2 , Tae-Yong Kim  1 , Kyung Hun Lee  1 , Sae-Won Han  1 , Seock-Ah Im  1 , Tae-You Kim  1 , Yung-Jue Bang  1
Affiliations

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Kyoung-Min Cho et al. Oncologist. 2015 Aug.

Abstract
in English, Chinese

Background: In advanced biliary tract cancer (BTC), the metabolic landscape has not been evaluated by (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) yet. Furthermore, reports of the clinical implications of these metabolic features are limited. We aimed to evaluate the metabolic features and their clinical relevance in advanced BTC using (18)F-FDG PET.

Patients and methods: We consecutively enrolled patients with advanced BTC who underwent (18)F-FDG PET prior to palliative chemotherapy between 2003 and 2013. We evaluated the findings of PET, such as SUV(max), the number of lesions and organs with FDG uptake, pathologic findings, and clinical outcomes.

Results: A total of 106 patients were enrolled: (53 intrahepatic cholangiocarcinoma [ICC], 7 extrahepatic BTC, 30 gallbladder cancer [GB Ca], and 16 ampulla of Vater cancer [AoV Ca]). The median SUV(max) differed according to the primary origin (ICC, 9.10; extrahepatic BTC, 5.90; GB Ca, 9.10; and AoV Ca, 6.37; p = .008) and histologic differentiation (well differentiated, 4.95; moderately differentiated, 6.60; poorly differentiated, 14.50; p = .004). Patients in the high metabolic group (SUV(max) of ≥7.5) had more poorly differentiated histology and more organs and lesions with FDG uptake than did those in the low metabolic group (SUV(max) of <7.5). The low metabolic group had a significantly longer OS (11.4 vs. 7.4 months, p = .007) and PFS (6.6 vs. 4.3 months, p = .024) than high metabolic group. In multivariate analysis, SUV(max) was a significant prognostic factor for overall survival (OS; p = .047) and progression-free survival (PFS; p = .039).

Conclusion: Metabolic characteristics of advanced BTC differ according to primary origin and histology. These metabolic features could be prognostic factors for OS and PFS in advanced BTC.

摘要

背景。在晚期胆道癌(BTC)患者中,尚未通过18F-氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)来进行代谢特征评估。此外,这些代谢特征临床意义的报告是有限的。我们的目标是使用18F-FDG PET 来评估晚期 BTC 的代谢特征和其临床相关性。

患者与方法。我们在 2003 年至 2013 年之间连续招募了在接受姑息性化疗前接受过18F-FDG PET 的晚期 BTC 患者,并且我们评估了 PET 的结果,如 SUVmax、有摄取 FDG 的病灶和器官之数量、病理结果和临床预后。

结果。总共有 106 例患者入选:[53 例肝内胆管癌(ICC)患者、7 例肝外 BTC 患者、30 例胆囊癌(GB Ca)患者和 16 例壶腹部癌(AoV Ca)患者)]。中位 SUVmax 根据原发部位(ICC:9.10;肝外 BTC:5.90;GB Ca:9.10;以及 AoV Ca:6.37;p = 0.008)和组织学分化(高分化:4.95;中分化:6.60;低分化:14.50;p = 0.004)而有所不同。与低代谢组(SUVmax < 7.5)的患者相比,高代谢组(SUVmax ≥ 7.5)的患者有更多的组织学低分化以及摄取 FDG 的更多病灶和器官。与高代谢组相比,低代谢组明显有更长的总生存期(OS)(11.4 对比 7.4 个月,p = 0.007)以及无进展生存期(PFS)(6.6 对比 4.3 个月,p = 0.024)。在多变量分析中,SUVmax 是总生存(OS;p = 0.047)和无进展生存(PFS;p = 0.039)的一个显著预后因素。

结论。晚期 BTC 的代谢特征根据原发部位和组织学而有所不同。这些代谢特征在 BTC 中可能是 OS 和 PFS 的预后因素。 (The Oncologist) 2015;20:926–933

实践意义:晚期胆道癌的代谢特征及其临床意义尚未被研究。这项研究表明,晚期胆道癌的代谢特征根据原发部位和组织学而显著不同。而且,此代谢活性与患者的预后(包括总生存和无进展生存)相关。依据胆道癌的癌症代谢,这项研究支持肿瘤异质性。

Keywords: Advanced biliary tract cancer; Metabolism; Positron emission tomography; Prognosis; Standardized uptake value.

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Conflict of interest statement

Disclosures of potential conflicts of interest may be found at the end of this article.

Figures

Figure 1.
Figure 1.
Overall survival (OS) according to metabolic activity. Patients with low metabolism (SUVmax < 7.5) had a significantly longer OS than those with high metabolism (SUVmax > 7.5) (11.4 vs. 7.4 months, p = .007). Abbreviation: PET, positron emission tomography.
Figure 2.
Figure 2.
Progression-free survival according to metabolic activity. Patients with low metabolism had a significant longer PFS than those with high metabolism (6.6 vs. 4.3 months, p = .024). Abbreviation: PET, positron emission tomography.
See this image and copyright information in PMC

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