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肺癌是全球范围内病死率最高的恶性肿瘤,其中非小细胞肺癌(non-small-cell lung cancer, NSCLC)约占80%[1]。随着肺癌个体化治疗的发展,识别与靶向治疗相关的基因突变状态[如表皮生长因子受体(epidermal growth factor receptor, EGFR)突变]已成为优化治疗策略的重要依据。相较于传统有创的活体组织病理学检查,18F-FDG PET/CT属于无创分子影像学技术,一次采集即可获得病灶的功能和解剖信息,《中华医学会肿瘤学分会肺癌临床诊疗指南(2021版)》已推荐其用于肺癌的诊断、分期及预后预测[2];近年来有研究结果显示,其也可有效预测EGFR基因的突变状态[3]。笔者就18F-FDG PET/CT常规代谢参数及影像组学在预测EGFR基因突变状态方面的研究进展作一综述。
18F-FDG PET/CT预测非小细胞肺癌EGFR基因突变状态的新进展
The new progress of 18F-FDG PET/CT in predicting the mutation status of EGFR gene in non-small-cell lung cancer
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摘要: 肺癌是全球第2大常见癌症,其中非小细胞肺癌(NSCLC)为主要类型。在NSCLC的发展中,表皮生长因子受体(EGFR)起重要作用,并成为NSCLC治疗中的重要靶点。EGFR酪氨酸激酶抑制剂已被广泛用于NSCLC的靶向治疗中,并被证明可以有效延长EGFR基因突变患者的生存期,其疗效和预后与EGFR基因突变状态密切相关,18F-氟脱氧葡萄糖(FDG)PET/CT显像可以非侵入性地对NSCLC进行评估,在预测NSCLC的EGFR基因突变状态方面有重要意义。笔者就近期与EGFR基因突变状态相关的18F-FDG PET/CT代谢参数、影像组学研究新进展作一综述。
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关键词:
- 癌,非小细胞肺 /
- 基因,erbB-1 /
- 正电子发射断层显像术 /
- 体层摄影术,X线计算机 /
- 氟脱氧葡萄糖F18
Abstract: Lung cancer is the second most common cancer in the world, among which non-small-cell lung cancer (NSCLC) is the predominant type. Epidermal growth factor receptor (EGFR) plays an important role in the development of NSCLC and has become an important target in the treatment of NSCLC. Epidermal growth factor receptor-tyrosine kinase inhibitors have been widely used in the targeted therapy of NSCLC and have been shown to effectively prolong the survival of patients with EGFR mutations, and their efficacy and prognosis are closely related to those of EGFR gene mutations. 18F-fluorodeoxyglucose (FDG) PET/CT can non-invasively evaluate NSCLC and is of great significance in predicting EGFR gene mutation status in NSCLC. The authors review the recent advances in 18F-FDG PET/CT metabolic parameters and radiomics related to EGFR gene mutation status. -
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