治疗前^(18)F-FDG PET/CT在成人伯基特淋巴瘤诊断、分期及预后评价中的应用  

Value of Pretherapeutic ^(18)F-FDG PET/CT in the Diagnosis,Staging and Prognosis Evaluation of Adult Burkitt's Lymphoma

作　　者：丁重阳[1] 刘红宇[2] 郭喆[1] 李天女[1] 

机构地区：[1]南京医科大学第一附属医院核医学科,江苏南京210029 [2]浙江省台州市中心医院放射科,浙江台州31800

出　　处：《中国实验血液学杂志》2017年第2期438-443,共6页Journal of Experimental Hematology

摘　　要：目的:探讨治疗前^(18)F-FDG PET/CT在成人伯基特淋巴瘤(Burkitt's lymphoma,BL)的病灶检测、临床分期及预后评价中的价值。方法:回顾性分析2008年12月至2015年2在我院经病理确诊的18例成人BL患者的临床资料及治疗前^(18)F-FDG PET/CT显像资料,观察病灶的分布特点,测量病灶的最大标准摄取值(SUV_(max))及受累淋巴结的最大径。采用单因素方差分析对各组SUV_(max)进行比较;淋巴结大小与SUV_(max)的相关性采用Spearman相关性检验;采用Kaplan-Meier法对患者的预后进行生存分析。结果:18例患者治疗前^(18)F-FDG PET/CT显像均阳性,均可见淋巴结侵犯,其中最常累及的部位为腹腔淋巴结(9例,50%);结外软组织侵犯8例,胃肠道最常见(6/8,75%);7例患者可见骨髓浸润,其中表现为多发局灶型4例(4/7,57.1%)。淋巴结、结外软组织及骨髓病灶的SUV_(max)分别为11.7(3.4-28.5)、9.85(6.7-21.9)和11.8(5.6-23.8),3者差异无统计学意义(F=1.013,P=0.369)。2例(2/8,11.1%)患者的临床分期因PET/CT而发生改变,均为上调。单因素分析结果显示,仅有国际预后指数(international prognostic index,IPI)与患者的预后相关(χ2=6.602,P=0.010),而所有病灶及受累淋巴结的SUV_(max)低者与高者的预后均无统计学差异(P>0.05)。结论:成人BL病灶呈^(18)F-FDG高摄取,在其病灶检测及分期方面PET/CT显像具有优势,但在治疗前^(18)F-FDG PET/CT预测预后的价值不明确,目前尚不能通过其来判断患者的预后。Objective： To investigate the value of pretherapeutic ^18F-FDG PET/CT in the focus detection, staging and prognosis evaluation of adult Burkitt＇s lymphoma（BL）. Methods： The clinical data and detection results of ^18F-FDG PET/CT scan of 18 patients with BL before the treatment from December 2008 to February 2015 were analyzed retro- spectively. The lesions distribution were observed, the maximal standard uptake value（ SUVmax） of ^18F-FDG by lesions and the maximal diameter of lymph nodes were measured. One-way analysis of variance was used to analyze the SUV and the Spearman correlation was used to analyze the relationship between SUVmax and the maximum diameter of lymph nodes. The prognostic factors were analyzed by using Kaplan-Meier survival analysis. Results： ^18F-FDG PET/ CT showed 100% positive detection rate for 18 adults with BL, lymph nodal lesions were found in all the patients, and the most common area was lymphonodi coeliaci （9/18,50%）, 8 cases showed extranodal soft tissue involvement, 6 ca- ses showed gastrointestinal tract, bone marrow involvement was detected in 7 cases, out of which the mutiple-focal involvement was found in 4 cases. The median SUVmax of lymph nodes, extranodal soft tissue and bone marrow was 11.7 （ range of 3.4 to 28.5 ）, 9.85 （range of 6.7 to 21.9） and 11.8 （ range of 5.6 to 23.8 ）, respectively, there were no significant differences among these 3 types of lesions （ F = 1. 013, P = 0. 369 ）. And the median SUVmax of all lesions was 16.5 （ range of 8.8 to 28.5 ）. The clinical staging of 2 patients （2/8, 11.1% ） was changed by ^18F-FDG PET/CT imaging. The univariate analysis revealed that only the IPI （ international prognostic index） could be the prognostic factor （χ^2 = 6. 602, P = 0. 010）, but the prognosis was not different between the patients below and above the median SUV of all lesions and lymph node （ all P 〉0.05）. Conclusion： BL in adult is an intensely ^18F-FDG-avid tumor, the ^18F- FDG PET/CT is an effective

关 键 词：伯基特淋巴瘤 体层摄影术 ^18F-FDG PET/CT 发射型计算机 脱氧葡萄糖 

分 类 号：R733.1[医药卫生—肿瘤]