PET/CT与临床预后因素在弥漫大B细胞淋巴瘤疗效评价及预后评估中的应用  

Application of PET/CT and clinical factors in the therapeutic and prognostic evaluation of diffuse large B cell lymphoma

作　　者：秦文琼 高硕[1] 

机构地区：[1]天津医科大学总医院PET/CT中心,300052

出　　处：《国际放射医学核医学杂志》2017年第6期437-442,共6页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：弥漫大B细胞淋巴瘤（DLBCL）是最常见的侵袭性非霍奇金淋巴瘤（NHL）.应用美罗华联合环磷酰胺、阿霉素、长春新碱、甲泼尼龙化疗方案后,DLBCL患者的治愈率可达60%~80%.由于DLBCL在分子病理等方面具有明显的异质性,不同患者的疗效和预后不同,因此如何正确评价其疗效及预后是目前研究的热点.18F-FDG PET/CT是DLBCL患者常用的疗效评价及预后评估的影像学工具.国际预测预后指数（IPI）以及美国国立综合癌症网络-国际预后指标（NCCN-IPI）是广泛应用于临床的恶性淋巴瘤预后评分系统.近年来,一些新的临床及分子病理因素的预后价值也先后被探索.笔者将对PET/CT、临床预后评分系统、不同的临床及分子病理预后因素在DLBCL患者的疗效评价及预后评估中的应用、研究进展以及发展趋势进行综述.Diffuse large B-cell lymphoma（DLBCL） is a common aggressive non-Hodgkin lymphoma （NHL）. When rituximab combined with cyclophosphamide, doxorubicin, vincristine, and methylprednisolone chemotherapy regimen is applied, the cure rate of DLBCL patients can reach 60%-80%. However, DLBCL possesses prominent heterogeneity of molecular pathology, and different patients have different efficacies and prognoses. Therefore, the correct evaluation of efficacy and prognosis is the focus of the current study. 18F-FDG PET/CT is an imaging tool commonly used for DLBCL patients during therapeutic and prognostic evaluation. The international prognostic index（IPI） and the national comprehensive cancer network-international prognostic index （NCCN-IPI） are widely used clinical prognostic scoring systems for malignant lymphoma. Recently, the prognostic value of a number of new clinical and molecular pathological factors has been explored. This study reviews the application, research progress, and development trend of PET/CT, clinical prognostic score system, different clinical and molecular pathologic prognostic factors during treatment evaluation, and prognosis of DLBCL patients.

关 键 词：淋巴瘤 B细胞 正电子发射断层显像术 体层摄影术 X线计算机 标准化摄取值 疗效评价 预后 

分 类 号：R730.44[医药卫生—肿瘤] R733.1[医药卫生—临床医学]