骨髓摄取FDG弥漫增高征象在初诊弥漫性大B细胞淋巴瘤的临床价值探讨  

Clinical value of diffusely increased bone marrow ^(18)F-FDG uptake in patients with newly diagnosed diffuse large B-cell lymphoma

作　　者：李旭[1] 陈聪霞[1] 刘甫庚[1] 崔燕 朱辉[1] 姚稚明[1] LI Xu;CHEN Congxia;LIU Fugeng;CUI Yan;ZHU Hui;YAO Zhiming(Department of Nuclear Medicine,Beijing Hospital,National Center of Gerontology,Chinese Academy of Medical Sciences,Beijing 100730 China)

机构地区：[1]北京医院核医学科国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中国辐射卫生》2021年第6期762-766,共5页Chinese Journal of Radiological Health

基　　金：北京医院院内基金资助项目(BJ-2015-111)。

摘　　要：目的探讨初诊弥漫大B细胞淋巴瘤(Diffuse large B-cell lymphoma,DLBCL)患者骨髓摄取氟代脱氧葡萄糖(FDG)弥漫增高征象的临床价值。方法回顾性分析在我院行PET/CT检查的114例初诊DLBCL住院患者。所有患者均行骨髓活检(Bone marrow biopsy,BMB)。计数数据分析用χ^(2)检验,计量数据分析用t检验或Wilcoxon检验。结果根据骨髓摄取FDG类型分为骨髓正常组(51.8%)、单纯局灶组(10.5%)、单纯弥漫组(28.1%)、弥漫+局灶组(9.6%),诊断骨髓受累的比例分别为0%、100%、15.6%和100%,IV期的比例分别为33.9%、100%、59.4%、100%。单纯弥漫组患者比骨髓正常组更年轻(57±17岁vs 70±13岁)、血红蛋白(Haemoglobin,HGB)水平更低(108.1±23.8 g/dL vs 119.4±19.0 g/dL)、IV期和B症状发生频率更高(59.4%和46.9%vs 33.9%和22.0%)差异有统计学意义,(P<0.05);性别比例、白细胞计数(White blood cell,WBC)、乳酸脱氢酶(Lactate dehydrogenase,LDH)升高率、国际预后指数(IPI)评分>2比例无统计学差异。结论DLBCL初诊患者中,骨髓摄取FDG弥漫增高患者比骨髓摄取FDG正常者更年轻,更容易发生骨髓受累、分为IV期,更容易出现贫血、B症状、LDH升高、IPI评分>2,这些提示其病情更重、预后可能更差。Objective To investigate the clinical value of diffusely increased bone marrow ^(18)F-fluorodeoxyglucose(^(18)F-FDG)uptake in patients with newly diagnosed diffuse large B-cell lymphoma(DLBCL).Methods A retrospective analysis was performed on the clinical data of 114 inpatients who underwent positron emission tomography(PET)/computed tomography examination and were newly diagnosed with DLBCL.All patients underwent bone marrow biopsy.The Chisquare test was used to analyze categorical data,and the t-test or Wilcoxon test was used to analyze continuous data.Results According to the type of bone marrow ^(18)F-FDG uptake,the patients were divided into normal bone marrow group(nPET,51.8%),only focal group(fPET,10.5%),only diffuse group(odPET,28.1%),and focal+diffuse group(f+dPET,9.6%),with proportions of bone marrow involvement of 0%,100%,15.6%,and 100%,respectively,and proportions of stage IV lymphoma of 33.9%,100%,59.4%,and 100%,respectively.Compared with the nPET patients,the odPET patients were significantly younger(57±17 y vs 70±13 y),and had a significantly lower hemoglobin level(108.1±23.8 g/dL vs 119.4±19.0 g/dL)and significantly higher proportions of stage IV lymphoma and B symptoms(59.4%,46.9%vs 33.9%,22.0%,all P<0.05).There were no significant differences in sex ratio,white blood cell count,frequency of lactate dehydrogenase(LDH)increase,and the proportion of International Prognostic Index(IPI)score>2.Conclusion Among patients with newly diagnosed DLBCL,patients with diffusely increased bone marrow ^(18)F-FDG uptake are younger than those with normal bone marrow ^(18)F-FDG uptake.They are more prone to bone marrow involvement,stage IV lymphoma,anemia,B symptoms,elevated LDH,and IPI score>2,which suggest a more serious condition and possibly worse prognosis.

关 键 词：氟代脱氧葡萄糖 弥漫大B细胞淋巴瘤 骨髓弥漫摄取 骨髓受累 血红蛋白 B症状 

分 类 号：Q691[生物学—生物物理学]