应用18F-FDG PET/CT评估不同CD5表达的弥漫大B细胞淋巴瘤化疗疗效及价值  

Value of 18F-FDG PET/CT in Evaluating Chemotherapeutic Effect of Diffuse Large B Cell Lymphoma Patients with Different CD5 Expression

作　　者：杨明[1] 冯彦林[1] 冼伟均[1] 鲁胜男[1] 王颖[1] 李雯[1] 黄克敏[1] YANG Ming;FENG Yanlin;XIAN Weijun;LU Shengnan;WANG Ying;LI Wen;HUANG Kemin(Department of Nuclear Medicine,The First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院核医学科

出　　处：《肿瘤防治研究》2019年第10期926-931,共6页Cancer Research on Prevention and Treatment

基　　金：2015年佛山市医学类科技攻关项目(2015AB00325)

摘　　要：目的应用18F-FDG PET/CT评估不同CD5表达的弥漫大B细胞淋巴瘤(DLBCL)患者化疗效果及影响治疗效果的因素。方法回顾性分析55例初诊DLBCL患者PET/CT表现,应用Deauville 5分法(5-PS)标准,比较CD5(+)和CD5(-)的DLBCL患者化疗效果是否存在差异,并分析年龄、性别、Ann Arbor分期、B症状、侵犯部位、乳酸脱氢酶(LDH)、国际淋巴瘤预后指数(IPI)和SUVmax在不同CD5表达的DLBCL患者中是否有差异。结果不同CD5表达患者年龄、性别、SUVmax值高低差异无统计学意义(P=0.105、0.931、0.203);不同CD5表达患者Ann Arbor分期、有无B症状、侵犯部位、LDH、IPI评分差异有统计学意义(P=0.005、0.037、0.014、0.003、0.029);CD5(-)化疗效果好于CD5(+)(P=0.018);年龄、性别、SUVmax均不是影响化疗疗效的独立因素(P=0.050、0.230、0.179),而Ann Arbor分期、有无B症状、侵犯部位、LDH、IPI评分则是影响化疗疗效的独立因素(P=0.007、0.006、0.043、0.020、0.015)。结论CD5(+)患者化疗效果较差,在随访周期内易复发或者出现新病灶;CD5表达和性别、SUVmax值变化无相关性;除年龄、性别、SUVmax因素外,Ann Arbor分期、B症状、侵犯部位、LDH、IPI评分都可显著影响化疗效果。Objective To evaluate the chemotherapy effect on diffuse large B-cell lymphoma(DLBCL)patients with different CD5 expression by 18F-FDG PET/CT,and discuss related influence factors.Methods We retrospectively analyzed the PET/CT manifestation of 55 patients initially diagnosed as DLBCL.Deauville 5-score(5-PS)standard was applied to compare the chemotherapy effect between DLBCL patients with CD5(+)and CD5(-),and analyze if there was difference in age,gender,Ann Arbor staging,B symptoms,invasion position,LDH,IPI or SUVmax in DLBCL patients with different CD5 expression.Results There was no significant difference in age,gender or SUVmax between CD5(+)and CD5(-)DLBCL patients(P=0.105,0.931,0.203);while there was significant difference in Ann Arbor staging,B symptoms,nodal or extranodal,LDH,IPI(P=0.005,0.037,0.014,0.003,0.029).The therapeutic effect on patients with CD5(-)was better than those with CD5(+)(P=0.018).Age,gender,SUVmax were not independent influence factors for chemotherapeutic effect(P=0.050,0.230,0.179),while Ann Arbor staging,B symptoms,nodal or extranodal,LDH and IPI were independent influence factors(P=0.007,0.006,0.043,0.020,0.015).Conclusion DLBCL patients with CD5(+)are prone to recurrence or new lesions in the follow-up period.There is no correlation between CD5 expression and gender or SUVmax.Ann Arbor staging,B symptoms,nodal or extranodal,LDH and IPI are independent influence factors for chemotherapeutic efficacy.

关 键 词：弥漫大B细胞淋巴瘤 18F-FDG PET/CT CD5抗原 乳酸脱氢酶 国际淋巴瘤预后指数 化疗疗效 

分 类 号：R733.4[医药卫生—肿瘤] R730.44[医药卫生—临床医学]