检验医学与临床2025，Vol.22Issue(22)：3050-3055,6.DOI:10.3969/j.issn.1672-9455.2025.22.005
18F-FDG PET/CT代谢参数联合血清SGK1、FAT4对结直肠癌淋巴结转移的诊断价值
Diagnostic value of 18F-FDG PET/CT metabolic parameters combined with serum SGK1 and FAT4 for lymph node metastasis in colorectal cancer
摘要
Abstract
Objective To explore the diagnostic value of 18F-fluorodeoxyglucose positron emission tomo-graphy/computed tomography(18F-FDG PET/CT)metabolic parameters combined with serum levels of ser-um and glucocorticoid-induced protein kinase 1(SGK1)and fat atypical cadherin 4(FAT4)for lymph node metastasis of colorectal cancer(CRC).Methods A total of 120 CRC patients who underwent surgical treat-ment in this hospital from January to December 2023 were selected and divided into the metastasis group(58 cases)and non-metastasis group(62 cases)according to the lymph node metastasis status confirmed based on the postoperative pathological results.The serum SGK1 and FAT4 levels in all patients were determined by the enzyme-linked immunosorbent assay(ELISA).The correlations between the serum SGK1 and FAT4 lev-els in CRC patients with the 18F-FDG PET/CT metabolic parameters[maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV),and total lesion glycolysis(TLG)]were analyzed by the Pearson correlation.The multivariate Logistic regression was used to analyze the factors affecting the lymph node me-tastasis of CRC.The receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic effi-ciency of 18F-FDG PET/CT metabolic parameters and serum SGK1 and FAT4 for lymph node metastasis of CRC.Results There were statistically significant differences in the TNM stage and differentiation degree be-tween the non-metastasis group and metastasis group(P＜0.05).SUVmax in the metastasis group was lower than that in the non-metastasis group(P＜0.05),while MTV and TLG were higher than those in the non-me-tastasis group(P＜0.05).The serum SGK1 level in the metastasis group was higher than that in the non-me-tastasis group(P＜0.05),and the serum FAT4 level was lower than that in the non-metastasis group(P＜0.05).The Pearson correlation analysis results showed that the serum SGK1 level was negatively correlated with SUVmax(r=-0.486,P＜0.001)and positively correlated with MTV and TLG(r=0.481,0.508,both P＜0.05);the serum FAT4 level was positively correlated with SUVmax(r=0.491,P＜0.001)and negatively correlated with MTV and TLG(r=-0.472,-0.526,both P＜0.001).The multivariate Logistic regression analysis results showed that the TNM stage Ⅲ+Ⅳ,low differentiation and elevated serum SGK1 level were the risk factors for lymph node metastasis of CRC(P＜0.05),while the elevated serum FAT4 level was a protective factor for lymph node metastasis of CRC(P＜0.05).The areas under the curves(AUCs)of SUVmax,MTV,TLG,serum SGK1 and serum FAT4 alone and their combination for diagnosing the lymph node metastasis of CRC were 0.758(95％CI:0.671-0.832),0.819(95％CI:0.738-0.883),0.771(95％CI:0.686-0.843),0.802(95％CI:0.720-0.869),0.825(95％CI:0.744-0.888)and 0.926(95％CI:0.864-0.966)respectively.The AUC of the five-item combination diagnosis was greater than that of SUVmax(Z=3.427,P=0.001),MTV(Z=2.469,P=0.014),TLG(Z=3.365,P=0.001),SGK1(Z=2.828,P=0.005)and FAT4(Z=2.400,P=0.016)alone.Conclusion The serum SGK1 level is elevated and the ser-um FAT4 level is decreased in CRC patients with lymph node metastasis.The two indicators are correlated to the metabolic parameters of 18F-FDG PET/CT.The 5-item combination of SUVmax,MTV,TLG,serum SGK1 and serum FAT4 has a high diagnostic value for lymph node metastasis of CRC.关键词
结直肠癌/淋巴结转移/18F-FDG PET/CT/血清和糖皮质激素诱导蛋白激酶1/脂肪非典型钙黏蛋白4/诊断Key words
colorectal cancer/lymph node metastasis/18F-FDG PET/CT/serum and glucocorticoid-induced kinase 1/fat atypical cadherin 4/diagnosis分类
医药卫生引用本文复制引用
党春江,刘伟,韩俊杰,王毅刚,房琳..18F-FDG PET/CT代谢参数联合血清SGK1、FAT4对结直肠癌淋巴结转移的诊断价值[J].检验医学与临床,2025,22(22):3050-3055,6.基金项目
河北省医学科学研究课题计划项目(20231841). （20231841）
