Effect of NM23 expression on 18F-FDG PET/CT in non-small cell lung cancer radiotherapy schedule
-
摘要:
目的 分析NM23基因表达情况对非小细胞肺癌的生物学行为及对放疗计划的影响。 方法 以新疆医科大学附属肿瘤医院107例非小细胞肺癌患者为研究对象，在PET/CT影像下制定放疗方案，勾画一般靶区体积，危及器官受照量，按免疫组化结果分为NM23高表达组(n=43)和低表达组(n=64)，比较两组间PET/CT代谢参数最大标准化摄取值、PET/CT图像下勾画的放疗大体靶区体积、危及器官受照量的差异。 结果 NM23高表达组与低表达组在PET/CT中代谢参数测量的最大标准化摄取值测量方面，高表达组最大标准化摄取值小于低表达组，差异有统计学意义（P < 0.05）；在NM23低表达组与NM23高表达组制定的放疗计划中，两组在大体靶区体积、危及器官的受照体积方面，NM23高表达组小于低表达组，差异有统计学意义（P < 0.05）。 结论 深入了解非小细胞肺癌患者NM23基因表达情况及其生物学行为，将PET/CT运用于放疗计划的制定中，能够为非小细胞肺癌患者放疗靶区的精准雕刻提供更多的参考信息。 Abstract:Objective To analyze the influence of NM23 gene expression status on the biological behavior of non-small cell lung cancer and on radiotherapy planning. Methods A total of 107 patients with non-small cell lung cancer in the Cancer Hospital of Xinjiang Medical University were taken as the study subjects, and the radiotherapy protocols were formulated under PET/CT images, the general target area volume outlined under PET/CT images, and the amount of critical organs irradiated, which were divided into high NM23 expression group(n=43) and low NM23 expression group(n=64) according to the results of immunohistochemistry, and the differences in the maximal standardized uptake value of metabolic parameters of PET/CT, the PET/CT images, the volume of the radiotherapy macroscopic target area outlined under the images, and the differences in the amount of critical organs irradiated were compared. Results The maximum standardized uptake value of metabolic parameters measured in PET/CT in the NM23 high-expression group was smaller than that of the low-expression group, and the difference was statistically significant (P < 0.05). In the radiotherapy plans formulated by the NM23 low-expression group and the NM23 high- expression group, the volume of the macroscopic target area, and the volume of the organs at risk of radiation were smaller than that of the low-expression group in the NM23 high-expression group, and the differences were statistically significant (P < 0.05). Conclusion In-depth understanding of NM23 gene expression and its biological behavior in NSCLC patients, and the use of PET/CT in the development of radiotherapy plans can provide more reference information for the precise sculpting of radiotherapy targets in non-small cell lung cancer patients. -
图 1 NM23高表达组与NM23表达低表达组PET/CT图像
Figure 1. PET/CT images of NM23 high expression group and NM23 low expression group. A: NM23 high expression, SUVmax=10.8; B: NM23 low expression, SUVmax=15.1.
图 2 独立样本t检验估算图
Figure 2. Estimation diagram of independent sample t-test. A: SUVmax; B: GTVPET/CT; ***P < 0.05.
图 3 NM23基因表达的NSCLC病理图，低倍（×200，A）和高倍（×400，B）HE染色
Figure 3. Pathological images of NSCLC with NM23 gene expression, A: Low power (×200), B: high power (×400), HE staining.
表 1 NSCLC中NM23阳性表达程度的SUVmax值及GTVPET/CT的比较
Table 1. Comparison of SUVmax and GTVPET/CT levels of NM23 positive expression in NSCLC (Mean±SD)
NM23 expression SUVmax GTVPET/CT（cm3） Low expression group（n=64） 14.42±6.35 78.35±6.78 High expression group（n=43） 9.18±4.14 64.37±5.58 t 4.769 11.205 P ＜0.001 ＜0.001 SUVmax: Maximum standardized uptake value; GTV: Gross target volumn. 
下载: 导出CSV
表 2 NM23表达程度不同危及器官靶区受照量比较
Table 2. Comparison of NM23 expression levels in target areas of organs at risk (%, Mean±SD)
NM23 expression Double lungs V20 Heart V30 Esophagus V50 Low expression group（≤++, n=64） 33.54±5.38 17.80±1.76 13.07±1.38 High expression group（>++, n=43） 16.27±1.25 10.76±1.61 9.08±1.42 t 20.760 20.982 14.493 P ＜0.05 ＜0.05 ＜0.05
下载: 导出CSV
-
[1] Cao MM, Li H, Sun DQ, et al. Current cancer burden in China: epidemiology, etiology, and prevention[J]. Cancer Biol Med, 2022, 19(8): 1121-38. doi: 10.20892/j.issn.2095-3941.2022.0231 [2] Yang DW, Liu Y, Bai CX, et al. Epidemiology of lung cancer and lung cancer screening programs in China and the United States[J]. Cancer Lett, 2020, 468: 82-7. doi: 10.1016/j.canlet.2019.10.009 [3] 程传龙, 韩闯, 房启迪, 等. 基于时空地理加权回归模型探索肺癌发病的环境影响因素[J]. 山东大学学报: 医学版, 2023, 61(4): 95-102. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYB202304013.htm [4] 朱小琼, 蒋栋铭, 沈佳莹, 等. 不同人类发展指数国家肺癌发病率和死亡率分析[J]. 上海预防医学, 2023, 35(4): 305-13. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYI202304001.htm [5] 王泽洲, 郑莹. 1990年至2020年间全球及我国肺癌的发病流行趋势及防控措施[J]. 诊断学理论与实践, 2023, 22(1): 1-7. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDLS202301001.htm [6] Dissaux G, Visvikis D, Da-Ano R, et al. Pretreatment 18F-FDG PET/ CT radiomics predict local recurrence in patients treated with stereotactic body radiotherapy for early-stage non-small cell lung cancer: a multicentric study[J]. J Nucl Med, 2020, 61(6): 814-20. doi: 10.2967/jnumed.119.228106 [7] Delgado Bolton RC, Calapaquí-Terán AK, Giammarile F, et al. Role of 18F-FDG-PET/CT in establishing new clinical and therapeutic modalities in lung cancer. A short review[J]. Rev Española De Med Nucl E Imagen Mol Engl Ed, 2019, 38(4): 229-33. [8] Avanzo M, Stancanello J, Pirrone G, et al. Radiomics and deep learning in lung cancer[J]. Strahlenther Onkol, 2020, 196(10): 879-87. doi: 10.1007/s00066-020-01625-9 [9] Decazes P, Thureau S, Dubray B, et al. How to use PET/CT in the evaluation of response to radiotherapy[J]. Q J Nucl Med Mol Imaging, 2018, 62(2): 152-64. [10] 杨百路, 李紫艳, 张艳薇, 等. Claudin-1、E-cad、CyclinD1和nm23在不同分化肺腺癌中的表达及临床意义[J]. 中国当代医药, 2021, 28 (32): 37-9, 44, 241. doi: 10.3969/j.issn.1674-4721.2021.32.010 [11] 邱鹏. ERK2、nm23、MMP9的表达在乳腺病变中的意义[J]. 医学理论与实践, 2022, 35(17): 2997-9. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLL202217050.htm [12] 周红, 周江洪. 卵巢癌组织中DR-NM23的表达及对细胞增殖和转移的影响[J]. 现代检验医学杂志, 2022, 37(1): 114-8. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYN202201023.htm [13] 潘纯国, 邬爱红, 刘珺. CD44v6、nm23-H1及BRMS1基因在非小细胞肺癌中表达与转移的关系[J]. 世界最新医学信息文摘, 2017, 17 (92): 17-8. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201792011.htm [14] 熊艳丽, 杨雪琴, 张诗珩, 等. Nm23-H1在小细胞肺癌中的表达及其与预后的关系[J]. 第三军医大学学报, 2014, 36(10): 983-6. https://www.cnki.com.cn/Article/CJFDTOTAL-DSDX201410002.htm [15] 周霖, 薛兴阳. Ⅰ期非小细胞肺癌病灶中nm23的表达及淋巴结微转移研究[J]. 中国肿瘤外科杂志, 2016, 8(4): 254-6, 259. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLWK201604010.htm [16] Ai C, Ma GZ, Deng YF, et al. Nm23-H1 inhibits lung cancer bonespecific metastasis by upregulating miR-660-5p targeted SMARCA5[J]. Thorac Cancer, 2020, 11(3): 640-50. doi: 10.1111/1759-7714.13308 [17] Wu CE, Zhuang YW, Zhou JY, et al. Nm23-H1 inhibits hypoxia induced epithelial-mesenchymal transition and stemness in nonsmall cell lung cancer cells[J]. Biol Chem, 2019, 400(6): 765-76. doi: 10.1515/hsz-2018-0351 [18] Boissan M, De Wever O, Lizarraga F, et al. Implication of metastasis suppressor NM23-H1 in maintaining adherens junctions and limiting the invasive potential of human cancer cells[J]. Cancer Res, 2010, 70(19): 7710-22. doi: 10.1158/0008-5472.CAN-10-1887 [19] 盛亚. Nm23-H1在电离辐射诱导肺癌A549细胞DNA双链断裂中的作用及其机制研究[D]. 重庆: 第三军医大学, 2017. [20] 张艳红, 魏秀平, 王京晔. 非小细胞肺癌患者核苷二磷酸激酶1和表皮生长因子受体表达情况及其临床意义[J]. 实用心脑肺血管病杂志, 2016, 24(10): 54-7. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXL201610015.htm [21] Li SJ, Huang J, Zhou XD, et al. Clinicopathological and prognostic significance of Oct-4 expression in patients with non-small cell lung cancer: a systematic review and meta-analysis[J]. J Thorac Dis, 2016, 8(7): 1587-600. doi: 10.21037/jtd.2016.06.01 [22] Chuang CH, Wang LY, Wong YM, et al. Anti-metastatic effects of isolinderalactone via the inhibition of MMP-2 and up regulation of NM23-H1 expression in human lung cancer A549 cells[J]. Oncol Lett, 2018, 15(4): 4690-6. [23] 罗猛, 朱大兴, 弓磊, 等. 慢病毒介导的稳定沉默nm23-H1基因的肺癌细胞株的建立及生物学行为改变[J]. 中国肺癌杂志, 2012, 15(3): 139-45. https://www.cnki.com.cn/Article/CJFDTOTAL-FAIZ201203004.htm [24] Takeda A, Sanuki N, Fujii H, et al. Maximum standardized uptake value on FDG-PET is a strong predictor of overall and disease-free survival for non-small-cell lung cancer patients after stereotactic body radiotherapy[J]. J Thorac Oncol, 2014, 9(1): 65-73. doi: 10.1097/JTO.0000000000000031 [25] Vaidya M, Creach KM, Frye J, et al. Combined PET/CT image characteristics for radiotherapy tumor response in lung cancer[J]. Radiother Oncol, 2012, 102(2): 239-45. doi: 10.1016/j.radonc.2011.10.014 [26] 江庆华, 王亚民, 汤在祥. 基于生存分析模型挖掘HSPB1基因表达与放疗敏感性关系研究[J]. 安徽医科大学学报, 2019, 54(2): 261-6. https://www.cnki.com.cn/Article/CJFDTOTAL-YIKE201902020.htm -
点击查看大图
图(3) / 表(2)
计量
- 文章访问数: 51
- HTML全文浏览量: 14
- PDF下载量: 5
- 被引次数: 0
