^(18)F-FDG PET/CT参数SUV_(peak)、全身代谢肿瘤体积和总糖酵解值对弥漫大B细胞淋巴瘤患者预后的预测价值  

Predictive value of ^(18)F-FDG PET/CT quantization parameters SUV_(peak),MTV and TLG in patients with diffuse large B-cell lymphoma

作　　者：翟威豪 何薇 ZHAI Weihao;HE Wei(Department of Nuclear Medicine,Huadong Hospital of Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学医学院附属华东医院核医学科,上海200040

出　　处：《分子影像学杂志》2021年第5期787-791,共5页Journal of Molecular Imaging

基　　金：上海市科委“科技创新行动计划”产学研医合作领域项目(19DZ1910302)。

摘　　要：目的探讨化疗前PET/CT检查的SUV_(peak)、代谢肿瘤体积(MTV)、总糖酵解值(TLG)是否可以预测弥漫大B细胞淋巴瘤患者的预后。方法回顾性分析2011年8月~2018年11月本院诊治的76例弥漫大B细胞淋巴瘤患者资料,根据随访结果将患者分为进展组(n=40)和未进展组(n=36)、死亡组(n=6)和存活组(n=70)。所有患者化疗前均接受^(18)F-FDG PET/CT检查,使用自动感兴趣区勾画软件测量记录病灶的SUV_(max)、SUV_(peak)、MTV、TLG等参数。比较疾病进展组和未进展组之间、死亡组和存活组之间PET参数的差异,通过ROC曲线求取PET参数的最佳临界值,并采用Kaplan-Meier生存分析比较生存率,使用临床变量资料和PET参数对生存期和疾病进展进行单因素和多因素分析。结果疾病进展组的中位SUV_(max)、SUV_(peak)、MTV和TLG分别为30.82(12.64~71.16)、19.89(9.35~52.23)、786.49(135.06~8795.16)cm^(3)、4618.76(653.88~37361.18);未进展组为34.53(3.82~52.41)、15.76(3.18~32.37)、116.05(54.14~2642.96)cm^(3)、420.18(276.97~9409.09)。进展组和未进展组之间SUV_(peak)、MTV及TLG差异有统计学意义(P<0.05)。死亡组的中位数SUV_(max)、SUV_(peak)、MTV和TLG分别为50.47(19.95~130.14)、37.40(16.95~82.63)、2195.11(231.85~8361.82)cm^(3)、14712.77(3371.5~28302.65);存活组为30.82(3.82~52.41)、19.43(3.18~38.62)、252.10(54.14~8795.16)cm^(3),1219.53(276.97~37361.18)。死亡组和存活组之间SUV_(max)、SUV_(peak)、MTV及TLG数值的差异均有统计学意义(P<0.05)。患者SUV_(peak)、MTV和TLG小于临界值时患者生存率明显高于其大于临界值时。SUV_(peak)、MTV、TLG及国际预后指数评分与无进展生存期呈显著相关。结论SUV_(peak)、MTV和TLG均能在弥漫大B细胞淋巴瘤患者的治疗预后中提供重要的预测价值。Objective To evaluate the predictive significance of F-18 FDG PET/CT quantization parameters SUV_(peak),MTV and TLG in patients with diffuse large B cell lymphoma(DLBCL)before chemotherapy.Methods Seventy-six patients with DLBCL were involved between August 2011 and November 2018 who had undergone F-18 FDG PET/CT scan prior to treatment.The patients were divided into progress group(n=40)and non-progressive group(n=36),death group(n=6)and survival group(n=70).Maximum standardized uptake value(SUV_(max)),peak standardized uptake value(SUV_(peak)),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were measured by a automatic VOI software.The differences in PET parameters between the progression group and the non-progressive group,and between the death group and the survival group were compared.The best cut-off value of PET parameters through the ROC curve was obtained.Kaplan-Meier survival analysis was used to compare survival rates.The clinical variables Data and PET parameters were used for univariate and multivariate analysis of survival and progression.Results The median SUV_(max),SUV_(peak),MTV and TLG in the progression group were 30.82(12.64-71.16),19.89(9.35-52.23),786.49(135.06-8795.16)cm^(3) and 4618.76(653.88-37361.18),and 34.53(3.82-52.41),15.76(3.18-32.37),116.05(54.14-2642.96)cm^(3) and 420.18(276.97-9409.09)in the non-progressive group.The differences in SUV_(peak),MTV and TLG between progressive group and non progressive group were significant(P<0.05).The median SUV_(max),SUV_(peak),MTV and TLG were 50.47(19.95-130.14),37.40(16.95-82.63),2195.11(231.85-8361.82)cm^(3) and 14712.77(3371.5-28302.65)in the death group;and 30.82(3.82-52.41),19.43(3.18-38.62),252.10(54.14-8795.16)cm^(3) and 1219.53(276.97-37361.18)in the survival group.The differences in the SUV_(max),SUV_(peak),MTV,and TLG between the dead group and the survival group were significant(P<0.05).The survival rate of patients when SUV_(peak),MTV and TLG are less than the cut-off value was significantly higher than when they are great

关 键 词：PET/CT 弥漫大B细胞淋巴瘤 定量参数 预后价值 无进展生存率 

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