Abstract
PurposeTumor promote disease progression by reprogramming their metabolism and that of distal organs, so it is of great clinical significance to study the changes in glucose metabolism at different tumor stages and their effect on glucose metabolism in other organs.MethodsA retrospective single-centre study was conducted on 253 NSCLC (non-small cell lung cancer) patients with negative lymph nodes and no distant metastasis. According to the AJCC criteria, the patients were divided into different groups based on tumor size: stage IA, less than 3 cm (group 1, n = 121); stage IB, greater than 3-4 cm (group 2, n = 64); stage IIA, greater than 4-5 cm (group 3, n = 36); and stage IIB, greater than 5-7 cm (group 4, n = 32). All of the patients underwent baseline 18F-FDG PET/CT scans, and the primary lesion SUVmax (maximum standardized uptake value), liver SUVmean (mean standardized uptake value), spleen SUVmean, TLR (Tumor-to-liver SUV ratio) and TSR (Tumor-to-spleen SUV ratio) were included in the study, combined with clinical examination indicators to evaluate DFS (disease free survival).ResultsIn NSCLC patients, with the increase in the maximum diameter of the tumor, the SUVmax of the primary lesion gradually increased, and the SUVmean of the liver gradually decreased. The primary lesion SUVmax, liver SUVmean, TLR and TSR were related to disease recurrence or death. The best predictive parameters were different when the tumor size differed. SUVmax had the highest efficiency when the tumor size was less than 4 cm (AUC:0.707 (95% CI, 0.430-0.984) tumor size < 3 cm), (AUC:0.726 (95% CI, 0.539-0.912) tumor size 3-4 cm), liver SUVmean had the highest efficiency when the tumor size was 4-5 cm (AUC:0.712 (95% CI, 0.535-0.889)), and TLR had the highest efficiency when the tumor size was 5-7 cm [AUC:0.925 (95%CI, 0.820-1.000)].ConclusionsIn patients with early NSCLC, glucose metabolism reprogramming occurs in the primary lesion and liver. With the increase in tumor size, different metabolic parameters should be selected to evaluate the prognosis of patients.
Highlights
Lung cancer is an important global health problem
Using the imaging and clinical characteristics of all patients to conduct univariate survival analysis, we found that SUVmax, liver SUVmean, differentiation, Fib and so on were prognostic factors of disease-free survival (DFS), with area under the curve (AUC) of 0.621 for SUVmax, 0.612 for liver SUVmean, 0.671 for to-liver ratio (TLR), 0.632 for to-spleen ratio (TSR), 0.525 for pathology, 0.585 for differentiation, 0.523 for thrombin time (TT) and 0.602 for Fib (Table 2)
Tumor Larger Than 5 cm to 7 cm In patients with a tumor size of 5-7 cm, we found that higher TLR (HR: 1.3, 95% CI, 1.1-1.6, P
Summary
Lung cancer is an important global health problem. In 2020, more than 1.8 million people worldwide died of lung cancer. The metabolic regulation of tumor is not limited to the scope of tumor, related studies have mentioned that tumor can affect the metabolic level of other organs [8, 9]. This finding suggests that the metabolic level of both the primary tumor and other organs will change dynamically with the progression of the tumor. How to accurately use glucose metabolism to evaluate tumor prognosis at different stages needs further research. We retrospectively studied the changes in the metabolism of tumor of different sizes and their effects on the metabolism of the liver and spleen in NSCLC. Metabolic changes were further combined with clinical indicators to investigate the risk factors affecting disease-free survival (DFS)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
