18F-FDG PET／CT对淋巴瘤放化疗后疗效评估及无进展生存期预测的价值  

Value of 18F-FDG PET/CT in evaluation of curative effect and progression-free survival on lymphoma

作　　者：李思源[1] 徐文贵[2] 童冠圣[1] 张丽[1] 文哲[1] Li Siyuan Xu Wengui Tong Guansheng Zhang Li Wen Zhe(Department of Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China)

机构地区：[1]首都医科大学北京世纪坛医院核医学科,100038 [2]天津医科大学附属肿瘤医院核医学科

出　　处：《国际肿瘤学杂志》2017年第5期361-365,共5页Journal of International Oncology

摘　　要：目的探讨18F氟脱氧葡萄糖（FDG）PET/CT对淋巴瘤放化疗后疗效评估及无进展生存期（PFS）的预测价值。方法回顾性分析85例淋巴瘤患者的临床资料。所有病例接受4～8个周期标准化化疗，前后均行18FFDG PET/CT检查，比较2年PFS率，评价其对接受放化疗的淋巴瘤患者疗效评估及PFS率预测的价值。结果本组病例发病以非霍奇金淋巴瘤（NHL）类型为主，发病部位以头颈淋巴结、纵隔、腹膜后为主。多数患者伴有脾脏肿大和局部病灶高代谢。霍奇金淋巴瘤（HL）PET/CT阴性组治疗完全缓解（CR）率明显高于阳性组（86.4%∶42.9%，P=0.038），且PET/CT阳性组与阴性组2年PFS率分别为42.9%和81.8%，差异具有统计学意义（χ2=7.70，P=0.006）。56例NHL患者治疗后35例达CR，13例达部分缓解（PR），8例达病情稳定（SD）或病情进展（PD），CR组、PR组、SD或PD组患者2年PFS率分别为89.7%、65.3%和19.4%，差异有统计学意义（χ2=12.41，P=0.002）。PET/CT显像对治疗后T细胞淋巴瘤（TCL）患者（χ2=13.85，P=0.001）、弥漫大B细胞淋巴瘤（DLBCL）患者（χ2=13.51，P=0.001）有很强的PFS率预测作用，对滤泡淋巴瘤（FL）患者（χ2=4.63，P=0.099）无预后预测作用。结论18FFDG PET/CT显像能很好地评价淋巴瘤的疗效，可早期预测预后，对治疗方案的选择具有一定的指导意义。ObjectiveTo evaluate the value of 18Ffluorodeoxyglucose （FDG） PET/CT in evaluation of curative effect and progressionfree survival （PFS） for lymphoma patients. MethodsThe data of 85 lymphoma patients were retrospectively analyzed. Before and after 48 cycles standardized chemotherapy, the patients were evaluated with 18FFDG PET/CT. The twoyear PFS rate was compared. The value of 18FFDG PET/CT in evaluation of curative effect and PFS for lymphoma patients received chemoradiotherapy was analyzed. ResultsThe non Hodgkin lymphoma （NHL） was the common type, and the common pathogenic sites were head and neck lymph nodes, mediastinum and retroperitoneum. The majority of patients were accompanied with spleen enlargement and local lesions with high metabolism. The complete remission （CR） rate of Hodgkin lymphoma （HL） patients in PET/CT negative group was significantly higher than that in positive group （86.4% vs. 42.9%, P=0.038）. The twoyear PFS rates in PET/CT positive group and negative group were 42.9% and 81.8%, and the difference was statistically significant （χ2=7.70, P=0.006）. Thirtyfive NHL patients achieved CR, 13 achieved partial remission （PR）, and 8 achieved stable disease （SD） or disease progression （PD）. The twoyear PFS rates in the CR group, PR group, SD or PD group were 89.7%, 65.3% and 19.4% respectively, and the difference was statistically significant （χ2=12.41,P=0.002）. PET/CT imaging had a strong PFS predictive effect on T cell lymphoma （TCL） patients （χ2=13.85, P=0.001） and diffuse large B cell lymphoma （DLBCL） patients （χ2=13.51, P=0.001）, and had no predictive effect on follicular lymphoma （FL） patients （χ2=4.63, P=0.099）. Conclusion18FFDG PET/CT can evaluate the curative effect of lymphoma effectively and early predict prognosis, and has great guiding significance in choosing therapeutic schedule.

关 键 词：淋巴瘤 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 x线计算机 预后 疗效评估 

分 类 号：R733.1[医药卫生—肿瘤]