ABSTRACT
Objective:To investigate the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging for the epidermal growth factor receptor (EGFR) mutations in patients with lung adenocarcinoma. Methods:From January 2013 to December 2017, a total of 146 patients (83 males, 63 females, age: (60.2±10.3) years) who were confirmed as lung adenocarcinoma by pathology and were examined by 18F-FDG PET/CT imaging and EGFR mutation testing in Shanxi Cancer Hospital were retrospectively analyzed. The differences of clinical characteristics (age, gender, smoking, tumor diameter, loymph node metastasis, distant metastasis, stage, thyroid transcripition factor-1 (TTF-1), NapsinA, cyiokeratin (CK)-7, Ki-67) and PET/CT parameters (maximun standardized uptake value (SUV max) of the primary tumor (pSUV max), SUV max of lymph node (nSUV max) and SUV max of distant metastasis (mSUV max)) between patients of EGFR mutation and EGFR wild type were analyzed using independent-sample t test, χ2 test and Fisher exact test. The predictors for EGFR mutation were analyzed by logistic regression analysis. The predictive value of pSUV max and pSUV max combined with gender, smoking and tumor diameter was determined by receiver operating characteristic (ROC) curve analysis. Results:There were 46.58%(68/146) patients with EGFR mutations and 53.42%(78/146) patients with wild type. Gender, smoking, lymph node metastasis, tumor diameter, pSUV max, nSUV max, TTF-1, NapsinA and Ki-67 were significantly different between patients with EGFR mutations and those with wild type ( t values: from -3.023 to -2.032, χ2 values: 4.725-33.749, all P<0.05). Female (odds ratio ( OR)=3.236, 95% CI: 1.213-8.779; P=0.029), non-smoker ( OR=4.947, 95% CI: 1.796-13.621; P=0.019), tumor diameter<3.5 cm ( OR=2.750, 95% CI: 1.109-6.818; P=0.001) and pSUV max<9.1( OR=2.960, 95% CI: 1.227-7.141; P=0.016) were predictors of EGFR mutations in lung adenocarcinoma. The area under the curve (AUC) of pSUV max was 0.640 with the specificity of 43.6%(34/78)and the sensitivity of 27.9%(19/68), while the AUC of the four independent factors was 0.83 with the specificity of 71.8%(56/78) and the sensitivity of 83.8%(19/68). Conclusions:pSUV max is associated with mutant EGFR status. Moreover, the combination of pSUV max, gender, smoking and tumor diameter can enhance the predictive value on EGFR mutation status in patients with lung adenocarcinoma.
ABSTRACT
Objective To investigate elderly patients with thoracic radiotherapy nausea result after risk factors associated with radiation pneumonitis.Methods The clinical data of a total of 440 cases of cancer patients with chest radiation therapy during January 2010-January 2014 were collected retrospectively.Of them,76 cases of radiation pneumonitis after radiotherapy were compared with other patients.The unconditional Logistic regression analysis was used to analyze the relationship of radiation pneumonitis and different factors including smoking,pulmonary dysfunction,combination with chemotherapy,radiation dose,and radiation sites.Results Elderly incidence of radiation pneumonitis was 17.27％.Multivariate Logistic regression analysis revealed the chi-square value of smoking,pulmonary dysfunction,combined with chemotherapy,radiation dose,and radiation sites was significant correlation (x2 =16.936,19.633,11.531,17.133,10.178,P ＜0.05),and the correlation degree was gradually decreased from pulmonary dysfunction,radiation dose,smoking,combined chemotherapy,to radiation site.Conclusions Elderly patients with thoracic malignancies after radiotherapy had more radiation pneumonitis,which was related to smoking,previous chemotherapy PO2 ＜ 80％,combined with chemotherapy,radiation dose ≥ 55 Gy,and low-lung radiation.The correlation degree was gradually decreased from chemotherapy before PO2 ＜ 80％,the radiation dose ≥55 Gy,smoking,combined chemotherapy,to low-lung radiation.
ABSTRACT
Objective To investigate the in-stent restenosis after vertebral artery ostium stenting (VAOS),and to determine the risk factors for in-stent restenosis. Methods Respective analysis of clinical data of 775 cases received VAOS in Xuan Wu Hospital of Capital Medical University from Jan. 2006 to Dec. 2012. Severe stenosis of vertebral artery ostium were diagnosed by DSA,and followed-up by ultrasound. The risk factors were assessed by COX analysis for in-stent restenosis ≥50%. Results This study included 775 patients. Surgical success rate was 99. 87%(n=774),technique success rate was 99. 48%(n=771 ). Two patients had cerebral hemorrhage after operation,one of them was dead. Four patients had cerebral infarction. The mean follow-up period was 12 months. The restenosis rate was 35. 89%(234/652 ). 79. 91% of restenosis occurred within 12 months after operation. COX analysis showed the vessels diameter after stenting was the independent predictors of in-stent restenosis (P<0. 01). The in-stent restenosis rate of drug-eluting stents was lower than metal-bare stents (HR 0. 532,95%CI 0. 397-0. 713,P<0. 01). Conclusion The in-stent restenosis was peculiarly prone to the smaller vessels diameter after VAOS. Drug-eluting stents were superior to metal-bare stents in preventing in-stent restenosis.