摘要
目的:探讨^(18F)-FDG PET/CT显像定量参数最大标准摄取值(SUVmax)、肿瘤代谢容积(MTV)、糖酵解总量(TLG)及其他临床因素对弥漫大B细胞淋巴瘤预后判断的价值。方法:回顾性分析65例初治且病理诊断为DLBCL患者的临床及PET/CT影像资料,所有患者均接受R-CHOP方案一线治疗,均于化疗前及化疗中期(2-4个疗程后)行18F-FDG PET/CT扫描,分别计算获得患者的SUVmax、MTV及TLG。应用受试者工作特征曲线(ROC)确定各自最佳分界值,Pearson卡方检验、Kaplan-Meier生存曲线、log-rank检验和单因素及多因素Cox回归分析评价相关参数对PFS的判断价值。结果:年龄、B症状、Ann Arbor分期及结外主要器官受累均与疾病复发或进展显著相关(P <0.05),SUVmax相关参数与预后关系无统计学意义,MTV0、MTV1、TLG0及TLG1预测疾病复发或进展的最佳分界值分别是172.20 cm^3、4.32 cm^3、1043.33 g及14.07 g,低MTV及低TLG组PFS均有延长且有统计学意义,多因素Cox回归分析显示,B症状、MTV1和TLG1是疾病的独立预后危险因素。结论:治疗前及治疗中MTV和TLG以及NCCN-IPI均与患者预后相关,SUVmax相关参数与预后无显著相关性,而治疗中MTV及TLG是DLBCL独立危险预后因素,比NCCN-IPI更具有预后意义。
Objective:To investigate the prognostic value of 18F-FDG PET/CT scan quantization parameters,max standardized uptake value(SUVmax),metabolic tumor volume(MTV),total lesion glycolysis(TLG)and other clinical factors for prognostic evaluation of paticnts with diffuse large B-cell lymphoma(DLBCL).Methods:PET/CT scan and clinical data of a total of 65 newly diagnosed DLBCL patients who received Rituximab plus cyclophosphamide,doxorubicin,vincristine and prednisone(R-CHOP)chemotherapy as first-line treatment were analyzed.All patients received a PET/CT scan at diagnosis and an interim PET/CT after 2-4 circles of chemotherapies.The related parameters of SUVmax,MTV and TLG were acquired by analyzing and calculating the scan results.The receiver operating characteristic(ROC)curve was used to determine the optimal cut-off of parameters.Pearson chisquare test,Kaplan-Meier method and COX proportional hazard model were performed to analyze the prognostic value of PET/CT related parameters and clinical factors in progression-free survival(PFS).Results:Age,B symptom,Ann Arbor stage and extra-nodal involvement in major organs significantly related with PFS(P<0.05),but the SUVmax didn't relalt with the prognosis.The cut-off values of MTV0,MTV1,TLG0 and TLG1 for disease recurrence or progression were 172.20cm3,4.32cm3,1043.33g and 14.07g.The lower MTV and TLG groups showed longer PFS significantly.In the multivariate Cox regression model,B symptoms,MTV1 and TLG1 were the independent prognostic risk factors.Conclusion:MTV and TLG at baseline and in the interim and NCCN-IPI correlate with disease prognosis.SUVmax related parameters hare no significant relationship with prognosis.Besides MTV and TLG during treatment are the independent prognostic risk factors suggesting more predictive value than NCCN-IPI.
作者
张艺阳
陈威宇
崔应谱
高欣然
胡锦心
李臻臻
胡凯
ZHANG Yi-Yang;CHEN Wei-Yu;CUI Ying-Pu;GAO Xin-Ran;HU Jin-Xin;LI Zhen-Zhen;HU Kai(Department of Hematology,Third Hospital of Peking University,Beijing 100191,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2018年第5期1342-1349,共8页
Journal of Experimental Hematology
