摘要
目的探讨^18F—FDGPET／CT在滤泡性淋巴瘤（FL）的分期、疗效评价、复发监测及预后判断方面的临床价值。方法回顾性分析2005年12月至2013年1月行PET／CT检查的经病理确诊为FL的28例患者[男12例，女16例，平均年龄57（36～82）岁]资料。对患者均进行AnnArbor临床分期，统计行PET／CT检查后临床分期改变情况。比较不同临床分期组间、病理高级别（3a＋3b级）组和低级别（1＋2级）组间SUVmax差异。28例中有17例行化疗后PET／CT检查和电话随访（10-88个月）监测疗效，比较疗效佳（CR＋PR）和不佳（SD＋PD）者生存差异。统计分析采用Mann—Whitneyu秩和检验、Wilcoxon符号秩检验和Kaplan—Meier生存分析。结果（1）28例治疗前行^18F—FDGPET／CT的患者中，10．7％（3／28）分期上调，3．6％（1／28）分期下调。Ⅰ＋Ⅱ期组SUVmax为10．1±3．2，Ⅲ＋Ⅳ期组SUVmax为11．5±4．9，差异无统计学意义（z=-0．619，P〉0．05）。病理低级别组（15例）和高级别组（13例）SUVmax分别为6．9±3．6和12．4±5．6（Z=-3．706，P〈0．01）。（2）17例治疗前后均行^18F-FDGPET／CT检查的患者中，疗效佳组（11例）治疗前SUV～10．8±5．1，治疗后SUVmax3．4±2．3（Z=-2．312，P〈0．05）；疗效不佳组（6例）治疗前SUVmax11．2±6．9，治疗后SUVmax7．8±3．3，差异无统计学意义（Z=-1．153，P〉0．05）。疗效佳与疗效不佳组的中位无进展生存期（PFS）分别为48和26个月（x^2=4．207，P〈0．05）。结论^18F-FDGPET／CT有助于明确FL分期、评价疗效、监测复发及提示预后。
Objective To investigate the clinical value of ^18F-FDG PET/CT in staging, therapeutic response evaluation, relapse early detection and prognostic prediction of follicular lymphoma （FL）. Methods Twenty-eight patients （12 males, 16 females; average age 57 （36-82） years） with pathologically confirmed FL from December 2005 to January 2013 were enrolled. All patients underwent ^18F-FDG PET/CT before treatment. The SUVmax of different staging groups, different pathological grade groups （high： 3a＋3b; low： 1＋2） was compared. Seventeen of 28 patients underwent PET/CT after chemotherapy and received phone follow-up （10-88 months） to monitor the progress of treatment. Survival difference was analyzed. Mann-Whitney u test, Wilcoxon signed-rank test and Kaplan-Meier survival analysis were used for data a- nalysis. Results （1） The initial clinical staging without ^18F-FDG PET/CT based on Ann Arbor standard changed in 4 cases （up-staging in 3 cases, down-staging in 1 case） after the PET/CT scan. The ^18F-FDG uptake （ SUVmax ） in patients of stage Ⅰ/Ⅱ and stage Ⅲ/Ⅳ was 10.1±3.2 and 11.5±4.9, respectively （Z = -0.619,P〉0. 05）. The SUVmax in patients of the low grade group （6.9±3.6, n= 15） was significantly lower than that of the high grade group （ 12.4±5.6, n= 13） （Z=-3.706,P〈0.01）. （2） 17 patients underwent PET/CT scan both before and after chemotherapy, the pre-treatment SUVmax and post-treatment SUVmax were significantly different in CR＋PR group （ 10.8±5.1 vs 3.4±2.3; Z=-2.312, P〈0.05）, while there was no significant difference in SD＋PD group （11.2±6.9 vs 7.8±3.3; Z=-1.153, P〉0.05）. There was a significant difference in the median progress-free survival time between the CR＋PR group and the SD＋PD group （ 48 months vs 26 months ; x^2 = 4.207, P〈0.05）. Conclusion is F-FDG PET/CT has an advantage in clinical staging, therapeutic evaluation, relapse monitoring and prognosis predicting of FL.
出处
《中华核医学与分子影像杂志》
CSCD
北大核心
2014年第3期179-182,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
