The Relationship Between 18F-FDG Uptake on PET/CT and Markers of Systemic Inflammatory Response in Patients Undergoing Surgery for Intrahepatic Cholangiocarcinoma

Anticancer Res. 2019 Jan;39(1):341-346. doi: 10.21873/anticanres.13117.

Abstract

Background/aim: This study evaluated the prognostic relationship between tumor 18F-fluorodeoxyglucose (FDG) uptake on positron-emission tomography (PET)/computed tomography (CT) imaging and markers of systemic inflammatory response (SIR) in patients undergoing surgery for intrahepatic cholangiocarcinoma (ICC).

Patients and methods: Between 2002 and 2016, 94 patients with ICC who underwent 18F-FDG-PET scans before surgery were analyzed. 18F-FDG uptake was quantified as a maximum standardized uptake value (SUVmax). The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and C-reactive protein (CRP) were selected as SIR markers.

Results: There was no strong correlation between SUVmax and, NLR, PLR and CRP (all Pearson's |r| <0.40). Multivariate Cox regression analyses identified high tumor SUVmax (≥8) and high NLR (≥5) as independent predictors of poor overall survival (p=0.013 and p=0.002) and disease-free survival (p<0.001 and p=0.004).

Conclusion: Prognostic information provided by tumor SUVmax and SIR markers may be independent prognostic factors in patients undergoing surgery for ICC.

Keywords: 18F-FDG-PET; intrahepatic cholangiocarcinoma; systemic inflammation.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Cholangiocarcinoma / diagnostic imaging*
  • Cholangiocarcinoma / pathology
  • Cholangiocarcinoma / surgery
  • Disease-Free Survival
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage*
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Lymphocytes / metabolism
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Positron Emission Tomography Computed Tomography
  • Prognosis*
  • Proportional Hazards Models
  • Systemic Inflammatory Response Syndrome / blood
  • Systemic Inflammatory Response Syndrome / diagnostic imaging*
  • Systemic Inflammatory Response Syndrome / surgery

Substances

  • Biomarkers, Tumor
  • Fluorodeoxyglucose F18