Relationship between FDG PET/CT multiple characteristics and tumor proliferation in surgically resected non-small cell lung cancer

Objectives: To evaluate the relationship between multiple parameters on ¹⁸F-FDG PET/CT and the expression level of Ki-67 in patients with surgically resected non-small cell lung cancer (NSCLC). Methods: A total of 151 patients (113 males, 38 females; age: (63.7±11.2) years) with I-IIIa stage and surgically resected NSCLC who underwent ¹⁸F-FDG PET/CT for initial evaluation were enrolled. PET/CT parameters of the primary tumors including maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) and diameter were measured. Ki-67 labeling index (Ki-67 LI) was detected in the primary tumors by immunohistochemical staining. Correlation of parameters with Ki-67 LI were analyzed. Mann-Whitney U test, χ² test and univariate and multivariate linear regression analysis were used for statistical analysis.

Results: Both Ki-67 LI (0.68±0.23 vs 0.47±0.31) and metabolic parameters of squamous cell carcinoma were significantly higher than those of adenocarcinoma (P<0.05). The univariate analysis showed significant correlations between SUVmax, SUVmean, MTV, TLG, diameter, stage and Ki-67 LI in adenocarcinoma (r=0.689, 0.684, 0.338, 0.375, 0.375, 0.321, all P<0.05), as well as between SUVmax, SUVmean, TLG and Ki-67 LI in squamous cell carcinoma (r=0.465, 0.447, 0.347, all P<0.05). However, multivariate regression revealed that SUVmax and MTV were positively related with Ki-67 LI in adenocarcinoma (β=0.652, 0.236, all P<0.05), and only SUVmax had a predictive value in squamous cell carcinoma (β=0.465, P<0.01). Conclusions: Primary SUVmax and MTV could reflect the tumor proliferation activity in patients with surgically resected NSCLC, and adenocarcinoma may differ from squamous cell carcinoma somewhat.

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