^18F—FDG PET—CT在弥漫大B细胞淋巴瘤预后判断中的价值  

Prognostic value of lSF-FDG PET-CT in patients with diffuse large B-cell lymphoma

作　　者：黄斌[1] 李天女[2] 丁重阳[2] Huang Bin Li Tiannyu Ding Chongyang(Department of Oncology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China)

机构地区：[1]南京大学医学院附属鼓楼医院肿瘤科,210008 [2]南京医科大学第一附属医院核医学科,210029

出　　处：《白血病．淋巴瘤》2017年第9期523-527,共5页Journal of Leukemia & Lymphoma

基　　金：2016中央高校基本科研业务费专项资金（021414380147）;南京医科大学“十二五”校级教育研究课题（JYY2015108）

摘　　要：目的探讨^18F-FDG PET-CT在弥漫大B细胞淋巴瘤（DLBCL）预后判断中的价值。方法回顾性分析2009年6月至2015年5月130例初诊DLBCL患者的临床资料及治疗前18F-FDG PET-CT检查结果。 结果130例DLBCL患者18F-FDG PET-CT检查的最大标准摄取值（SUVmax）、病灶代谢体积（MTV）及病灶糖酵解总量（TLG）的中位数分别为19.93、34.45 cm^3、459.92。单因素分析结果显示：美国东部肿瘤协作组（ECOG）评分、Ann Arbor分期、β2微球蛋白水平、乳酸脱氢酶水平、肿瘤直径、骨髓侵犯、改良国际预后指数（NCCN-IPI）评分、MTV、TLG均是患者无进展生存（PFS）率及总生存（OS）率的影响因素（均P〈0.05）；年龄是患者PFS率的影响因素（P〈0.05）。由于MTV与TLG高度相关，多因素分析时，二者中仅纳入TLG，结果显示：ECOG评分、Ann Arbor分期、NCCN-IPI评分及TLG是影响患者PFS率的独立因素（均P〈0.05）；NCCN-IPI评分及TLG是影响患者OS率的独立因素（均P〈0.05）。根据NCCN-IPI评分和TLG将患者分为低危组、中危组和高危组。低、中、高危组患者3年PFS率分别为66.0%、36.8%、26.1%，3年OS率分别为70.0%、49.1%、39.1%，差异均有统计学意义（均P〈0.05）。结论18F-FDG PET-CT所测得的TLG是影响DLBCL患者PFS及OS的独立预后因素，对DLBCL患者预后判断具有一定的参考价值。Objective To investigate the prognostic value of ISF-FDG PET-CT in patients with diffuse large B-cell lymphoma （DLBCL）. Methods The clinical data of 130 DLBCL patients from June 2009 to May 2015 and pretreatment ISF-FDG PET-CT were retrospectively analyzed. Results The 130 DLBCL patients＇ median of maximal standard uptake value （SUVmax）, metabolic tumor volume （MTV）and total lesion glycolysis （TLG） was 19.93, 34.45 cm^3, 459.92 respectively. Univariate analysis showed that the affecting factors of progression-free survival （PFS） and overall survival （OS） rate included Eastern Cooperative Oncology Group （ECOG） grade, Ann Arbor stage, β2-MG, lactate dehydrogenase level, tumor-diameter, bone marrow involvement, National Comprehensive Cancer Network International Prognostic Index （NCCN-IPI）, MTV and TLG （all P 〈 0.05）, while age was related with PFS rate （P 〈 0.05）. As MTV and TLG were strongly correlated, only TLG measure was used for multivariate analysis. The result showed that ECOG grade, Ann Arbor stage, NCCN-IPI and TLG were statistically significant predictors of PFS rate, and NCCN-IPI and TLG were independent factors of OS rate （all P 〈 0.05）. According to TLG and NCCN-IPI, the patients were divided into three groups： low risk group, mediate risk group and high risk group. The 3-year PFS rates of these groups were 66.0 %, 36.8 % and 26.1% respectively （P 〈 0.05）, and the 3-year OS rates of these groups were 70.0 %, 49.1% and 39.1% respectively （P 〈 0.05）. Conclusion TLG in ^18F-FDG PET-CT is an independent prognostic factor for PFS and OS in patients with DLBCL, which has a reference value for prognosis of DLBCL.

关 键 词：淋巴瘤 大B-细胞 弥漫性 预后 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R730.44[医药卫生—肿瘤]