Diagnostic Value of 18F-FDG PET/CT Parameters Combined with Serum FOXM1 for Lymph Node Metastasis in Colorectal Cancer

To evaluate the diagnostic value of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and metabolic tumor volume (MTV) in 18F-FDG PET/CT combined with serum forkhead box protein M1 (FOXM1) for detecting lymph node metastasis (LNM) in colorectal cancer (CRC).

A retrospective study was conducted on 107 CRC patients who underwent 18F-FDG PET/CT and serum FOXM1 testing, with postoperative pathology as the reference standard. Patients were divided into LNM-positive (n=52) and LNM-negative (n=55) groups. PET/CT metabolic parameters (SUVmax, TLG, MTV) and serum FOXM1 levels were compared, correlations were analyzed by Spearman's test, and receiver operating characteristic (ROC) curves were plotted to assess diagnostic efficacy.

SUVmax was significantly higher in LNM-negative patients, whereas TLG, MTV, and serum FOXM1 were higher in LNM-positive patients (all P<0.05). Serum FOXM1 showed negative correlation with SUVmax (r=-0.356) and positive correlation with TLG and MTV (r=0.564, 0.549). The combined model of SUVmax, TLG, MTV, and FOXM1 yielded the highest diagnostic performance (AUC=0.971, sensitivity=92.2%, specificity=94.3%).

SUVmax, TLG, MTV, and FOXM1 are interrelated and, when combined, provide superior diagnostic value for CRC LNM, though validation in larger, multicenter cohorts is needed.