[18F]-FDG PET-CT 在恶性黑色素瘤中的应用

Background/Objectives : Malignant melanoma (MM) is an aggressive neoplasm with a rising global incidence. Accurate staging and risk stratification are essential for guiding therapeutic decisions and improving patient prognosis. [18F]-FDG PET-CT enables the non-invasive assessment of tumor metabolic activity, offering a valuable adjunct to histopathological evaluation.

However, the correlation between PET-CT findings and established prognostic markers in MM, such as Breslow thickness, ulceration, and mitotic rate, remains insufficiently explored. Methods : This retrospective observational study included 61 patients diagnosed with MM, of whom 48 met the inclusion criteria. Quantitative and qualitative variables such as SULmax, Breslow thickness, Ki-67 expression, and mitotic rate were analyzed using descriptive statistics, while correlations between PET-CT findings, SLNB, and histopathological characteristics were assessed using Spearman's correlation test. A p -value < 0. 05 was considered statistically significant.

Results : Significant associations were identified between ulceration and both overall metastases ( p = 0. 01) and pulmonary metastases ( p = 0. 02). Breslow thickness showed a positive correlation with metastatic spread ( p = 0. 01), reinforcing its role as a key prognostic indicator.

Perineural and vascular invasion were significantly associated with intra-abdominal metastases ( p < 0. 001 and p = 0. 0007, respectively). Tumor-infiltrating lymphocytes (TILs) were inversely correlated with intra-abdominal metastases ( p = 0. 05), while sentinel lymph node positivity correlated with the presence of regional ( p = 0. 008) and distant ( p = 0. 02) metastases.

Additionally, subcutaneous SULmax values were significantly higher in male patients compared to females ( p = 0. 04). Conclusions : Integrating PET-CT metabolic parameters with histopathological markers enhances the assessment of MM aggressiveness and metastatic potential. By refining risk stratification, PET-CT may contribute to personalized therapeutic strategies and improved patient management in MM.