PET／CT用于评估弥漫大B细胞淋巴瘤预后的Meta分析  

Meta analysis of PET/CT in evaluating prognosis of diffuse large B-cell lymphoma

作　　者：梁立莉[1] 岑洪[2] 谭晓红[2] 郭宝平[2] 熊春[1] 马智[1] 何莎[2] 黄丹[1] 谢淑琼[1] LIANG Lili CEN Hong TAN Xiaohong GUO Baoping XIONG Chun MA Zhi HE Sha HUANG Dan XIE Shuqiong(Department of Oncology, the First Affiliated Hospital of Guangxi University of Science and Technology, Li- uzhou 545002, Chin)

机构地区：[1]广西科技大学第一附属医院肿瘤科,广西柳州545002 [2]广西医科大学附属肿瘤医院淋巴血液及儿童肿瘤内科,530000

出　　处：《临床肿瘤学杂志》2017年第1期41-47,共7页Chinese Clinical Oncology

基　　金：国家自然科学基金地区科学基金资助项目(81160298)

摘　　要：目的评价PET/CT在预测弥漫大B细胞淋巴瘤(DLBCL)预后中的价值。方法计算机检索Pub Med、万方、Cochrane Library、EMBASE、中国知网、Medline等数据库中关于PET/CT评价DLBCL预后的研究,检索年限均为2000年1月至2015年3月。采用STATA11.0统计学软件进行Meta分析,各效应量均以95%可信区间(CI)表示。分析治疗中期PET/CT参数最大标准摄取值(SUV_(max))、治疗末期SUV_(max)和肿瘤代谢体积(MTV),并应用Meta分析合并风险比(HR)来评价DLBCL患者治疗后的预后与PET/CT参数的关系。分析各纳入研究结果间的异质性,采用随机效应模型对各研究结果进行Meta分析。评价指标包括无进展生存期(PFS)和总生存期(OS)的HR。结果共纳入11项研究,包括1068例初诊的DLBCL患者。Meta分析结果显示:(1)治疗中期(2~4化疗周期后)PET/CT SUV_(max)评价DLBCL患者PFS的HR为1.50(95%CI:1.12~2.01,P=0.007);(2)治疗末期(6~8化疗周期后)PET/CT SUV_(max)评价DLBCL患者PFS的HR为1.30(95%CI:0.74~2.29,P=0.369),评价DLBCL患者OS的HR为1.75(95%CI:0.74~4.17,P=0.204);(3)治疗末期PET/CT MTV评价DLBCL患者PFS的HR为2.17(95%CI:1.46~3.24,P=0.000),评价DLBCL患者OS的HR为2.99(95%CI 1.91~4.69,P=0.000)。结论治疗中期PET/CT的SUV_(max)可以预测患者的PFS;治疗末期PET/CT的MTV可以预测患者的PFS、OS,而SUV_(max)则不能预测患者的PFS、OS。Objective To evaluate the prognostic value of PET/CT in the diffuse large B-cell lymphoma（DLBCL）. Methods All studies published up from January 2000 to March 2015 on the PET/CT in evaluating prognosis of DLBCL were searched from PubMed,Wan fang, Cochrane library, EMBASE, CNKI and Medline database. The STATA11.0 data analysis software was used for me- ta analysis. The effect of the volume was represented by 95% confidence intervals （CI）. The efficacy data included the maximum stand- ard uptake valne（SUVmax） Of the middle phase treatment and the SUVmax and metabolic tumor volume （MTV） at the end phase treat- ment. A meta analysis of the relationship between prognosis of DLBCL patients with these parameters was performed to generate com- bined hazard ratios （HRs） with 95% CI for overall survival （OS） and progression free survival（PFS）. Results Eleven studies, with 1068 patients in total diagnosed pathological types of DLBCL, were included for analysis. In the middle phase treatment （ after 2-4 cy- cles of chemotherapy）, the HR of PET/CT SUVmax in evaluating the PFS of DLBCL patients was[ 1.5 （ 1.12-2. 01 ）, P= 0. 007 ]. In the end phase treatment （after 6-8 cycles of chemotherapy） , the HR of PET/CT SUVmax in evaluating the PFS of DLBCL patients was [ 1.30 （0. 74-2. 29）, P=0. 369] ; the HR of PET/CT SUVmax in evaluating OS was[ 1.75 （0.74-4. 17）, P= 0. 204]. In the end phase treatment, the HR of PET/CT MTV in valuating PFS of DLBCL patients was[2. 17 （1.46-3. 24）, P=0. 000）]. The HR of PET/CT MTV in valuating the OS was [ 2. 99 （ 1.91-4. 69）, P = 0. 000 ]. Conclusion PET/CT SUVmax of middle treatment can be predicted PFS of patients with DLBCL. At the end of the treatment period, MTV of PET/CT can be predicted PFS and OS ,but PET/CT SUVmax cannot be predicted PFS and OS .

关 键 词：弥漫性大B细胞淋巴瘤 PET/CT 总生存期 无进展生存期 META分析 

分 类 号：R733[医药卫生—肿瘤]