18F-FDG PET/CT多参数及Deauville五分法在弥漫大B细胞淋巴瘤疗效评估和预后预测中的价值  

Value of F-FDG PET/CT Parameters and Deauville 5-point Scoring in Efficacy Evaluation and Prognosis Prediction of Diffuse Large B Cell Lymphoma Patients

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,佛山528000

出　　处：《肿瘤防治研究》2020年第8期611-616,共6页Cancer Research on Prevention and Treatment

摘　　要：目的探讨最大标准化摄取值(SUVmax)、SUVmax下降值(ΔSUVmax)、肿瘤代谢体积(MTV)、BCL-2、BCL-6蛋白表达对弥漫大B细胞淋巴瘤(DLBCL)患者预后的预测价值。方法回顾性分析55例DLBCL患者的18F-FDG PET/CT表现,应用18F-FDG PET/CT Deauville五分法(5-PS)评估中期化疗效果,应用卡方检验分析SUVmax、ΔSUVmax、MTV、BCL-2、BCL-6蛋白表达和疗效的相关性;用Kaplan-Meier生存分析和Cox回归法分析△SUVmax、Deauville标准、MTV、BCL-2、BCL-6蛋白对患者2年无疾病进展生存期(PFS)的预测价值。结果SUVmax与中期疗效无明显相关性(P>0.05);ΔSUVmax、MTV、BCL-2、BCL-6和疗效显著相关(P=0.029,0.005,0.001,0.014);单因素和多因素分析ΔSUVmax<10.6、MTV<30.1 cm3、Deauville<4分、BCL-6(-)各组2年PFS和ΔSUVmax≥10.6、MTV≥30.1 cm3、Deauville≥4分、BCL-6(+)各组比较差异均有统计学意义(P<0.05),BCL-2组仅单因素分析2年PFS差异有统计学意义(P=0.039)。结论ΔSUVmax、MTV和中期疗效呈负相关,BCL-2(-)、BCL-6(-)患者显示出好的疗效;ΔSUVmax、MTV、Deauville标准、BCL-6蛋白均是DLBCL患者2年PFS的独立影响因素。Objective To analyze the prognostic value of SUVmax,ΔSUVmax,MTV and BCL-2 and BCL-6 expression on DLBCL patients.Methods We retrospectively analyzed the 18F-FDG PET/CT manifestation of 55 DLBLC patients,and evaluated the middle-stage chemotherapy effect with 5-PS by 18F-FDG PET/CT scan.Chi-square test was used for analysing the correlation of the chemotherapy efficacy with SUVmax,ΔSUVmax,MTV and the expression of BCL-2 and BCL-6.Kaplan-Meier analysis and Cox regression analysis were used for the predictive value ofΔSUVmax,MTV,Deauville score and the expression of BCL-2 and BCL-6 on the 2-years PFS of DLBCL patients.Results There was no correlation between SUVmax and the middle-stage chemotherapy effect(P>0.05);ΔSUVmax,MTV and the expression of BCL-2 and BCL-6 were positively correlated with chemotherapy effect(P=0.029,0.005,0.001,0.014).By univariate and multivariate analyses,there were statistical differences in 2-years PFS betweenΔSUVmax<10.6,MTV<30.1 cm3,Deauville score<4,BCL-6(-)groups andΔSUVmax≥10.6,MTV≥30.1 cm3,Deauville score≥4,BCL-6(+)groups(P<0.05).There was statistical difference in 2-years PFS of the patients with BCL-2 by univariate analysis(P=0.039).Conclusion There are negatively correlation betweenΔSUVmax,MTV and the middle-stage chemotherapy effect.Patients with BCL2(-)and BCL-6(-)have good efficacy.ΔSUVmax,MTV,Deauville score and BCL-6 are independent prognostic factors for the 2-years PFS of DLBCL patients.

关 键 词：弥漫大B细胞淋巴瘤 脱氧葡萄糖 PET/CT SUVMAX 预后 

分 类 号：R733.4[医药卫生—肿瘤]