Association of pretreatment hematologic parameters with metabolic tumor burden on 18F-FDG PET/CT in gastric adenocarcinoma Association entre les paramètres hématologiques préthérapeutiques et la charge tumorale métabolique mise en évidence par TEP-TDM au 18F-FDG dans l’adénocarcinome gastrique
Medecine Nucleaire, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.mednuc.2026.09.002
- Dergi Adı: Medecine Nucleaire
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Anahtar Kelimeler: 18F-FDG PET/CT, Gastric adenocarcinoma, Metabolic tumor volume, Systemic inflammation, Total lesion glycolysis
- Eskişehir Osmangazi Üniversitesi Adresli: Evet
Özet
Introduction Systemic inflammation and tumor metabolic activity are closely interconnected in gastric adenocarcinoma and are both associated with disease progression and prognosis. Although hematologic inflammatory biomarkers and 18F-FDG PET/CT-derived metabolic parameters have each been investigated, the relationship between these biomarkers and volumetric PET parameters remains insufficiently characterized. This study aimed to evaluate the association between routinely available inflammatory biomarkers and PET/CT-derived metabolic tumor burden in patients with gastric adenocarcinoma. Methods This retrospective study included 61 consecutive treatment-naïve patients with newly diagnosed gastric adenocarcinoma who underwent baseline 18F-FDG PET/CT. Hematologic inflammatory markers, including neutrophil, lymphocyte, and platelet counts, mean platelet volume, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, monocyte-to-lymphocyte ratio, and the systemic immune-inflammation index, were analyzed. PET/CT metabolic parameters included SUVmax, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Correlation and multivariable linear regression analyses were performed. Results Platelet count demonstrated significant positive correlations with MTV (r = 0.417, P = 0.001) and TLG (r = 0.383, P = 0.002). In multivariable regression analyses, platelet count remained an independent predictor of both log(MTV) ( P = 0.014) and log(TLG) ( P = 0.004), whereas no independent associations were observed for SUV-based parameters. Patients with distant metastases and those who did not undergo surgery exhibited a more pronounced systemic inflammatory profile. Additionally, distal gastric tumors demonstrated significantly higher SUVmax and SUVmean values than proximal tumors. Conclusions Volumetric PET/CT parameters, particularly MTV and TLG, demonstrated stronger associations with systemic inflammatory status than conventional SUV-based metrics. Platelet count independently predicted metabolic tumor burden, suggesting that this inexpensive and readily available biomarker may serve as an indicator of metabolic tumor burden and complement PET/CT-derived volumetric assessment in the biological characterization and risk stratification of gastric adenocarcinoma. Prospective multicenter studies are warranted to validate these findings.