PET-CT的SUVmax在弥漫大B细胞淋巴瘤治疗中的应用  

Prognostic correlation and clinical application value of SUVmax value of PET-CT before and after treatment of diffuse large B-cell lymphoma

作　　者：杨刚 李亚青[1] 周志远[1] 柳喜洋[1] 张超[1] 张蕾[1] YANG Gang;LI Ya-qing;ZHOU Zhi-yuan;LIU Xi-yang;ZHANG Chao;ZHANG Lei(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肿瘤内科,郑州450052

出　　处：《医药论坛杂志》2018年第9期4-8,共5页Journal of Medical Forum

摘　　要：目的探讨治疗前及治疗4周期后的PET-CT的SUVmax的水平在弥漫大B细胞淋巴瘤患者中的临床疗效价值及预后相关性。方法 53例初治的弥漫大B细胞淋巴瘤患者以治疗前SUVmax0=10为阈值分为SUVmax0 <10和SUVmax0≥10两组,分析两组患者治疗前PET-CT的SUVmax0与治疗前LDH、IPI评分、Anarbor分期、Ki-67、CD5等多个因素的相关性、统计治疗4个周期后的缓解率,2年的PFS及OS等预后指标。53例患者根据疗效分为有效组和无效组,运用ROC曲线分析△SUVmax(治疗前SUVmax0与治疗4周期后SUVmax1之差)在PET-CT中对弥漫大B细胞淋巴瘤化疗4个周期后疗效的诊断效能。结果治疗前PET-CT的SUVmax0与Ann-Arbor分期、治疗前LDH水平、CD5阳性与否、IPI评分高低有统计学差异(P <0. 05),而与年龄、性别、有无B症状、有无骨髓浸润、生发或非生发中心、Ki-67水平、双(三)表达或打击无统计学差异(P> 0. 05)。SUVmax0 <10组和SUVmax0≥10组治疗4周期后的ORR和DCR比较均无显著性差异(P均> 0. 05)。SUVmax0 <10组和SUVmax0≥10组的2年PFS有统计学差异(P=0. 046),而两组的2年OS无统计学差异性(P=0. 131)。△SUV maxROC曲线下面积为0. 731,P=0. 039,有统计学差异,△SUVmax的最佳临界值为8. 4,PETCT的敏感度及特异性分别为57. 8%和87. 5%。结论治疗前PET-CT的SUVmax0与分期、治疗前LDH、CD5、IPI评分具有相关性,治疗前及治疗4个周期PET-CT的SUVmax对弥漫大B细胞淋巴瘤的预后及临床疗效评价具有一定的诊断价值。Objective This study was conducted to investigate the clinical efficacy and prognosis of PET-CT SUVmax levels before and after 4 cycles of treatment in patients with diffuse large B-cell lymphoma. Methods Totally 53 patients with newly diagnosed diffuse large B-cell lymphoma were divided into SUVmax0 10 and SUVmax0≥10 groups with the pre-treatment SUVmax0 = 10 as the threshold. The correlation between SUVmax0 of pre-treatment PET-CT and pre-treatment LDH,IPI score,Anarbor staging,Ki-67,CD5 and other factors was analyzed. The remission rate after 4 cycles of statistical treatment,2 years of PFS and prognostic indicators such as OS. According to the curative effect,53 patients were divided into effective group and ineffective group. The ROC curve was used to analyze the diagnostic efficacy of △SUVmax（ The difference between SUVmax0 before treatment and SUVmax1 after treatment for 4 cycles） in PET-CT after 4 cycles of diffuse large B-cell lymphoma chemotherapy. Results The pre-treatment PET-CT SUVmax0 and Ann-Arbor staging,pre-treatment LDH level,CD5 positive or not,IPI scores were statistically significant（ P〈0. 05）. And there was no statistical difference in age,gender,presence or absence of B symptoms,presence or absence of bone marrow infiltration,germinal or non-growth center,Ki-67 level,and double（ three） expression or combat（ P〉0. 05）. There was no significant difference in ORR and DCR between SUVmax0〈10 group and SUVmax0≥10 group after 4 cycles of treatment（ P〉0. 05）. The2-year PFS of the SUVmax0〈10 group and the SUVmax0≥10 group were statistically different（ P = 0. 046）,while the 2-year OS of the two groups was not statistically different（ P = 0. 131）. The area under the △SUVmaxROC curve was 0. 731,P = 0. 039,which was statistically different. The optimal cutoff value of ΔSUVmax was 8. 4,and the sensitivity and specificity of PET-CT were 57. 8% and 87. 5% respectively. Conclusion The SUVmax0 of PET-CT before treatment was correlated with staging,pre-treatment

关 键 词：非霍奇金淋巴瘤 弥漫大B细胞型淋巴瘤 SUVMAX CD5 化疗中期 相关性因素 

分 类 号：R733.4[医药卫生—肿瘤]