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目的 探讨18F-脱氧葡萄糖(FDG) PET/CT相关代谢参数对结直肠癌(CRC)患者Kras基因突变的预测价值.方法 回顾性分析2011年11月至2017年8月在海军军医大学附属长海医院行18F-FDG PET/CT检查的150例CRC患者(男105例,女45例,中位年龄63岁)资料,检查后1个月内行手术并检测Kras基因.18F-FDG PET/CT相关代谢参数包括最大标准摄取值(SUVmax)、代谢体积(MTV;包括MTV2.5、MTV20％、MTV30％、MTV40％、MTV50％)、病灶糖酵解总量(TLG;包括TLG2.5、TLG20％、TLG30％、TLG40％、TLG50％).采用logistic回归分析和受试者工作特征(ROC)曲线分析处理数据.结果 Kras基因突变型与野生型患者分别有78和72例.Logistic回归分析显示,SUVmax[比值比(OR)=1.176,95％ CI:1.043～1.327]和MTV2.5(OR=1.125,95％ CI:1.002～1.263)是CRC患者Kras基因突变的独立预测因素;以SUVmax=15.5、MTV2.5=23.79 cm3为阈值预测Kras基因突变的准确性分别为67.33％(101/150)和65.33％ (98/150);两者对直肠及乙状结肠癌亚组Kras基因突变的预测效能更高,准确性分别为70.79％ (63/89)和68.54％ (61/89).结论 SUVmax和MTV2.5可预测CRC患者Kras基因突变,但预测效能与病理基因检测尚有差距.“,”Objective To explore the predictive value of 18F-fluorodeoxyglucose (FDG) PET/CT related metabolic parameters for Kras mutation in colorectal cancer (CRC) patients.Methods Retrospective analysis was conducted in 150 patients (105 males,45 females,median age:63 years) with CRC who underwent 18F-FDG PET/CT in Changhai Hospital of Navy Medical University between November 2011 and August 2017.The primary tumors were removed by surgery and patients received genetic testing within 1 month after PET/CT.18F-FDG PET/CT related metabolic parameters were measured,including maximum standardized uptake value (SUVmax),metabolic tumor volume (MTV;including MTV2.5,MTV20％,MTV30％,MTV40％,MTV50％),total lesion glycolysis (TLG;including TLG2.5,TLG20％,TLG30％,TLG40％,TLG50％).Logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to analyze the data.Results There were 78 Kras-mutated type patients and 72 wild-type patients.Logistic regression analysis showed that SUVmax (odds ratio (OR) =1.176,95％ CI:1.043-1.327) and MTV2.5 (OR =1.125,95 ％ CI:1.002-1.263) were predictors of Kras mutation.With SUVmax =15.5 and MTV2.5 =23.79 cm3 as the cut-off value,the prediction accuracies of Kras mutation were 67.33％(101/150) and 65.33％(98/150),respectively.The accuracies of SUVmax and MTV2.5 for predicting Kras mutation were higher in recta or sigmoid colon cancers (70.79％(63/89) and 68.54％(61/89)).Conclusion SUVmax and MTV2.5 can predict Kras mutation in CRC patients,but there is a significant gap of predictive efficiency between PET/CT and gene detection.