基线^(18)F-FDG PET/CT在结外自然杀伤/T细胞淋巴瘤患者预后评估中的价值  

Prognostic value of baseline ^(18)F-FDG PET/CT in patients with extranodal NK/T-cell lymphoma

作　　者：来瑞鹤 孙一文[1] 李爱梅[1] 许守林[1] 蒋冲 Lai Ruihe;Sun Yiwen;Li Aimei;Xu Shoulin;Jiang Chong(Department of Nuclear Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院核医学科,210008

出　　处：《国际放射医学核医学杂志》2020年第11期671-678,共8页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨结外自然杀伤/T细胞淋巴瘤(ENKTL)患者治疗前^(18)F-氟脱氧葡萄糖(FDG)PET/CT代谢参数在其预后评估中的价值。方法回顾性分析37例在南京大学医学院附属鼓楼医院确诊为ENKTL患者的临床资料,其中男性27例、女性10例,中位年龄46(21~76)岁。根据患者不同生存状态分为无进展组、进展组和生存组、病死组。所有患者行PET/CT显像,测量各组患者的最大标准化摄取值(SUV_(max)),并以SUV>40%SUV_(max)的体素边界作为临界值,分别测量全身肿瘤代谢体积(MTV)和全身病灶糖酵解总量(TLG)。采用Mann-Whitney U检验评估2组的PET参数差异。应用受试者工作特征(ROC)曲线获得SUV_(max)、全身MTV和全身TLG的最佳临界值,根据PET参数最佳临界值将患者重新分为以临界值为界的不同组。采用Kaplan-Meier法及Log-rank检验预测2组间总生存期(OS)和无进展生存期(PFS)的差异。采用单因素分析法评估PET参数和临床变量的预后意义。采用Cox比例风险模型评估PET参数是否为OS和PFS的独立预后危险因素。结果无进展组的SUV_(max)、全身MTV和全身TLG的M(P25,P75)分别为10.8(6.9,14.4)、13.1(7.0,16.7)cm^(3)和53.81(34.1,97.4),进展组分别为11.7(9.5,17.8)、29.4(17.3,69.2)cm^(3)和183.5(125.1,725.3)。进展组的SUV_(max)、全身MTV和全身TLG均高于无进展组,且差异均有统计学意义(Z=−2.60、−3.28、−3.25,均P<0.01)。生存组的SUV_(max)、全身MTV和全身TLG的M(P25,P75)分别为9.9(6.7,12.7)、10.2(6.7,17.1)cm^(3)和52.4(33.4,90.4),病死组分别为12.3(9.9,18.7)、25.5(13.4,113.6)cm^(3)和187.8(110.0,1006.9)。病死组的SUV_(max)、全身MTV和全身TLG均高于生存组,且差异均有统计学意义(Z=−3.37、−3.11、−3.76,均P<0.01)。SUV_(max)、全身MTV和全身TLG以临界值为界的不同组患者OS的差异均有统计学意义(χ^(2)=5.12、13.07、15.51,均P<0.05);全身MTV和全身TLG以临界值为界的不同组的患者PFS的差异均有统计学意�Objective To demonstrate whether^(18)F-fluorodeoxyglucose(FDG)PET/CT metabolic parameters could predict the prognosis of patients with extranodal natural killer/T-cell lymphoma(ENKTL).Methods Thirty-seven patients,which comprise 27 males and 10 females,with a median age of 46(21-76)years and newly diagnosed with ENKTL in Nanjing Drum Tower Hospital,were retrospectively analysed.The patients were divided into progression-free group and progression group according to their disease progression status and into survival group and death group according to their survival status.The maximum standardized uptake value(SUV_(max))of each group was measured.Whole-body metabolic tumor volume(MTV)and whole-body total lesion glycolysis(TLG)were measured automatically using the threshold of 40%SUV_(max).Mann-Whitney U test was used to evaluate the difference in PET parameters between groups.The optimal critical value of systemic MTV and systemic TLG was obtained by using the receiver operating characteristic curve analysis.The patients were divided into high or low groups according to the optimal critical value of PET parameters.The differences in the overall survival(OS)and progression-free survival(PFS)between groups divided by PET parameters were predicted by Kaplan-Meier method and Log-rank test.Univariate analysis was used to evaluat.Results The M(P25,P75)of SUV_(max),whole-body MTV and whole-body TLG were 10.8(6.9,14.4),13.1(7.0,16.7)cm^(3)and 53.81(34.1,97.4)in the progressionfree group and 11.7(9.5,17.8),29.4(17.3,69.2)cm^(3)and 183.5(125.1,725.3)in the progression group,respectively.The SUV_(max),whole-body MTV and whole-body TLG of the progression group were higher than those of the progression-free group,and the difference was statistically significant(Z=−2.60,−3.28,−3.25;all P<0.01).The M(P25,P75)of SUV_(max),whole-body MTV and whole-body TLG were 9.9(6.7,12.7),10.2(6.7,17.1)cm^(3)and 52.4(33.4,90.4)in the survival group and 12.3(9.9,18.7),25.5(13.4,113.6)cm^(3)and 187.8(110.0,1006.9)in the death group.The SUV_(

关 键 词：淋巴瘤 结外NK-T细胞 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 肿瘤代谢体积 病灶糖酵解总量 

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