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肺癌是最常见的恶性肿瘤之一,同时也是癌症相关死亡的主要原因[1]。在新诊肺癌中,非小细胞肺癌(non-small cell lung cancer,NSCLC)占80%以上[2],且以腺癌多见。近年来,伴随对肺癌发病机制的深入研究,肺癌相关驱动基因不断被发现,进而出现了以肺癌驱动基因为靶点的分子靶向药物。分子靶向治疗可使伴有某些特定基因变异的肺癌患者的生存期明显延长,因此明确病灶的基因变异状态对临床治疗方案的选择非常关键。基因变异检测的“金标准”是组织标本的基因测序,然而获取理想的组织标本存在一定局限性。随着分子影像学的快速发展,通过无创的PET/CT检查来预测NSCLC患者的驱动基因突变状态成为了近年的研究热点。本文就18F-FDG PET/CT相关代谢参数与NSCLC的表皮生长因子受体(epidermal growth factor receptor,EGFR)、间变型淋巴瘤激酶(anaplastic lymphoma kinase,ALK)、鼠类肉瘤病毒癌基因(kirsten rate sarcoma viral oncogene homolog,KRAS)等驱动基因突变状态的相关性进行综述。
18F-FDG PET/CT代谢参数与非小细胞肺癌EGFR、ALK、KRAS突变的相关性研究进展
Research progress on the correlation between 18F-FDG PET/CT metabolic parameters and mutations of EGFR, ALK and KRAS in non-small cell lung cancer
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摘要: 非小细胞肺癌(NSCLC)是一类发病率和病死率均较高的恶性肿瘤,随着对其发病机制的不断深入研究,越来越多的肺癌驱动基因被发现,针对驱动基因的分子靶向治疗也取得了显著进展。因此,明确驱动基因的突变状态在临床的治疗决策中变得尤为重要。18F-氟脱氧葡萄糖(FDG) PET/CT在NSCLC的早期诊断、分期、疗效评价及预后评估等方面具有重要价值。此外,多项研究结果表明,18F-FDG PET/CT在预测NSCLC驱动基因突变状态方面也有一定价值。笔者重点对18F-FDG PET/CT相关代谢参数与NSCLC的表皮生长因子受体、间变型淋巴瘤激酶、鼠类肉瘤病毒癌基因等驱动基因突变状态的相关性作一综述。
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关键词:
- 癌,非小细胞肺 /
- 正电子发射断层显像术 /
- 体层摄影术, X线计算机 /
- 代谢参数 /
- 驱动基因
Abstract: Non-small cell lung cancer (NSCLC) is a malignant tumor with high morbidity and mortality. Considering the number of in-depth studies on its pathogenesis, the number of lung cancer driver genes that have been discovered is increasing. Molecular targeted therapy for driver genes has also made significant progress. Therefore, clarifying the mutation status of the driver gene in clinical treatment decisions is particularly important. 18F-fluorodeoxyglucose(FDG) PET/CT plays an important role in the early diagnosis, staging, efficacy evaluation, and prognosis evaluation of NSCLC. 18F-FDG PET/CT is valuable in predicting the mutation status of driver genes in NSCLC. This review focuses on the correlation between 18F-FDG PET/CT related metabolic parameters and the mutation status of epidermal growth factor receptor, anaplastic lymphoma kinase, kirsten rate sarcoma viral oncogene homolog, and other driver genes in NSCLC. -
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