Background:Following changes in primary tumor (T) and lymph node (N) staging for nasopharyngeal carcinoma (NPC) in the Eighth Edition AJCC Cancer Staging Manual, simplification of T staging has been proposed. However, a limited range of 2-deoxy-2-[fluorine-18] fluoro-D-glucose positron emission tomography–computed tomography (18F-FDG PET–CT) metabolic parameters has been investigated. Therefore, we aimed to evaluate the primary tumor invasiveness and the lymph node metastasis (LNM) of NPC from a metabolic perspective.Methods:A total of 435 NPC patients underwent 18F-FDG PET/CT before treatment were retrospectively examined. The primary endpoint was differences in standard uptake value (SUV), lean body mass-normalized SUV (SUL), body surface area-normalized SUV (SUS), glucose-normalized SUV (GN), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and glucose-normalized total lesion glycolysis (GNTLG) of primary tumors and LNM between different T and N stages. The metabolic parameters associated with T and N staging were identified.Results:There were significant differences between all parameters relative to the primary tumor but no significant differences in any parameter relative to the LNM and T stages. Higher mean values of TGNmax, TGNmean, TSUVpeak, and TSUSmax were associated with advanced T stages. Higher mean values of all the LNM parameters were associated with more advanced N stages. Only primary tumor metabolic tumor volume (TMTV), TSUVpeak, TSULmax, and TSUSmax showed a significant positive association with T staging, while lymph node metabolic tumor volume (LNMTV) and TSUSmax were significantly positive in N staging.Conclusions:Our findings suggest that metabolic parameters are useful indicators of tumor invasiveness and LNM based on the Eighth Edition manual. Compared with volume-dependent parameters, TGNmax, TGNmean, TSUVpeak, and TSUSmax may be better indicators of local tumor aggressiveness. SUSmax of the primary tumor was associated with LNM. In addition to SUVmax, other metabolic parameters (eg, SULmax, SUSmax, GNmax, and GNmean) could evaluate tumor aggressiveness and LNM better.

中文翻译：

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18F-FDG-PET-CT代谢参数在评估鼻咽癌原发肿瘤侵袭性和淋巴结转移中的应用

背景：随着第八版 AJCC 癌症分期手册中鼻咽癌 (NPC) 原发肿瘤 (T) 和淋巴结 (N) 分期的变化，提出了 T 分期的简化。然而，2-脱氧-2-[氟-18]氟-D-葡萄糖正电子发射断层扫描-计算机断层扫描的范围有限（1818F-FDG PET-CT）代谢参数已被研究。因此，我们旨在从代谢角度评估鼻咽癌的原发肿瘤侵袭性和淋巴结转移（LNM）。方法：共435例鼻咽癌患者接受了18回顾性检查治疗前的F-FDG PET/CT。主要终点是标准摄取值（SUV）、去脂体重标准化SUV（SUL）、体表面积标准化SUV（SUS）、葡萄糖标准化SUV（GN）、代谢肿瘤体积（MTV）、总病变的差异不同 T 期和 N 期之间原发肿瘤和 LNM 的糖酵解 (TLG) 和葡萄糖标准化总病变糖酵解 (GNTLG)。确定了与T和N分期相关的代谢参数。结果：所有参数相对于原发肿瘤均存在显着差异，但任何参数相对于LNM和T分期均无显着差异。TGN 平均值较高最大限度，TGN意思是, SUV顶峰、和 TSUS最大限度与晚期 T 期相关。所有 LNM 参数的平均值较高与较先进的 N 阶段相关。仅原发肿瘤代谢肿瘤体积（TMTV），TSUV顶峰, TSUL最大限度、和 TSUS最大限度与 T 分期呈显着正相关，而淋巴结代谢肿瘤体积 (LNMTV) 和 TSUS最大限度N分期显着阳性。结论：我们的研究结果表明，根据第八版手册，代谢参数是肿瘤侵袭性和LNM的有用指标。与体积相关参数相比，TGN最大限度，TGN意思是, SUV顶峰、和 TSUS最大限度可能是局部肿瘤侵袭性的更好指标。不锈钢最大限度原发肿瘤的大小与 LNM 相关。除了SUV最大限度，其他代谢参数（例如，SUL最大限度, 不锈钢最大限度, GN最大限度, 和 GN意思是）可以更好地评估肿瘤侵袭性和 LNM。