Correlation of 18F-FDG PET/CT metabolic parameters with clinical,pathological, and biological factors in patients with ovarian cancer after surgery

Abstract:

Objective：To investigate the correlation of maximum standard uptake value（SUVmax），metabolic tumor volume（MTV），and total lesion glycolysis（TLG） on 18F-FDG PET/CT with patient age，Federation International of Gynecology and Obstetrics（FIGO） stage，pathological classification，carbohydrate antigen 125（CA125），human epididymis protein-4（HE4），proliferation antigen Ki-67，tumor suppressor gene protein p53，and Wilms tumor gene product WT1 in patients with ovarian cancer after surgery. Methods：A retrospectively analysis was performed for the clinical data of 80 patients with ovarian cancer who underwent 18F-FDG PET/CT，and the metabolic parameters including SUVmax，MTV，and TLG were calculated. A rank sum test was used to investigate the correlation of the metabolic parameters with age，FIGO stage，pathological classification，CA125，HE4，Ki-67，p53，and WT1. Results：The patients with stage Ⅲ/Ⅳ ovarian cancer had a significantly higher SUVmax than those with stage Ⅰ/Ⅱ ovarian cancer（Z=-1.985，P=0.047），and the patients with positive expression of WT1 had a significantly higher SUVmax than those with negative expression of WT1（Z=-2.101，P=0.036）. The patients with high expression of CA125 and HE4 had a significantly higher MTV than those with low expression（Z=-2.323 and -2.981，P=0.020 and 0.003）. The patients with high expression of Ki-67 had a significantly higher MTV than those with low expression（Z=-2.134，P=0.033），and the patients with positive expression of p53 and WT1 also had a significantly higher MTV than those with negative expression（Z=-1.970 and -2.290，P=0.049 and 0.021）. The patients with high expression of HE4 had a significantly higher TLG than those with low expres－sion（Z=-2.712，P=0.007）. The patients with high expression of Ki-67 had a significantly higher TLG than those with low expression（Z=-2.198，P=0.028），and the patients with positive expression of p53 and WT1 had a significantly higher TLG than those with negative expression（Z=-2.356 and -2.751，P=0.018 and 0.005）. Conclusion：There is a certain degree of correlation between 18F-FDG PET/CT metabolic parameters and clinical/pathological/biological factors in patients with ovarian cancer after surgery. SUVmax is correlated with FIGO stage and WT1，and CA125，HE4，Ki-67，p53，and WT1 are closely correlated with MTV and TLG representing the degree of tumor burden. To a certain degree，MTV and TLG can reflect some features of patients with recurrence and metastasis after surgery for ovarian cancer and help to determine the degree of tumor malignancy and predict patient prognosis.