基线^(18)F-FDG PET/CT显像在滤泡性淋巴瘤分布、分级和分期中的价值  

The value of baseline^(18)F-FDG PET/CT imaging in the distribution,grading and staging of follicular lymphoma

作　　者：张欢 胡斌[1,3] 何柳[1,2] 顾程 张晓明 郑立春[1] ZHANG Huan;HU Bin;HE Liu;GU Cheng;ZHANG Xiaoming;ZHENG Lichun(Department of Nuclear Medicine,Tangshan Gongren Hospital,Hebei Tangshan 063000,China;Graduate School,North China University of Science and Technology,Hebei Tangshan 063000,China;Hebei Medical University,Hebei Shijiazhuang 050000,China)

机构地区：[1]唐山市工人医院核医学科,河北唐山063000 [2]华北理工大学研究生学院,河北唐山063000 [3]河北医科大学,河北石家庄050000

出　　处：《现代肿瘤医学》2023年第13期2496-2501,共6页Journal of Modern Oncology

基　　金：河北省省级科技计划基金资助项目(编号:182777145);河北省唐山市人才资助项目(编号:A202110028)。

摘　　要：目的:总结滤泡性淋巴瘤(follicular lymphoma,FL)基线^(18)F-FDG PET/CT显像特点并探讨基线^(18)F-FDG PET/CT显像不同代谢参数在FL分布、分级、分期中的价值。方法:回顾性分析2014年01月至2022年12月进行基线^(18)F-FDG PET/CT检查的经病理证实的FL患者56例,对其基线^(18)F-FDG PET/CT显像受累病灶的部位、密度及最大径进行总结分析;应用独立样本t检验比较FL低级别组(1、2级)、高级别组(3a、3b级)与Ki-67、SUV_(max)、TBR和D_(max)间的关系;分析FL局限期组(Ⅰ、Ⅱ期)与播散期组(Ⅲ、Ⅳ期)间SUV_(max)、TBR的差异。结果:基线^(18)F-FDG PET/CT显像最高代谢病灶最常见的好发部位是腹部和颈部淋巴结,多表现为腹部和颈部多发高代谢肿大淋巴结,密度均匀,较大者融合成团。高、低级别组Ki-67指数间差异有统计学意义(t=4.621,P<0.05),利用ROC曲线进行分析,Ki-67指数临界值为35%;高、低级别组间SUV_(max)、TBR差异有统计学意义(t=2.481、t=2.514,P<0.05),ROC曲线临界值分别为12.3、4.7,D_(max)差异无统计学意义(t=1.380,P>0.05)。局限期组与播散期组的SUV_(max)、TBR无统计学差异(t=0.534、1.212,P>0.05)。结论:FL基线^(18)F-FDG PET/CT显像多表现为腹部和颈部多发肿大淋巴结,密度均匀且融合成团,代谢活性不同程度增高,基线^(18)F-FDG PET/CT能有效评估FL患者分级并能够准确分期,代谢参数SUV_(max)、TBR越高,分级越高,但其与分期间无明显关联。Objective:To summarize the characteristics of baseline^(18)F-FDG PET/CT imaging of follicular lymphoma(FL)and to explore the value of different metabolic parameters of baseline^(18)F-FDG PET/CT imaging in the distribution,grading,and staging of FL.Methods:A retrospective analysis of 56 patients with pathologically confirmed FL who underwent baseline^(18)F-FDG PET/CT from January 2014 to December 2022 was performed,and the sites,densities,and maximum diameters of the involved lesions on their baseline^(18)F-FDG PET/CT imaging were summarized and analyzed.The independent samples t-test was applied to compare the relationship between FL low level group(level 1 and 2),high level group(level 3 a and 3 b)and Ki-67,SUV_(max),TBR and D_(max).The differences in SUV_(max)and TBR between the limited stage group(stage I and II)and the disseminated stage group(stage III and IV)were analyzed.Results:The most common prevalent sites of the highest metabolic lesions on baseline^(18)F-FDG PET/CT imaging were the abdominal and the neck lymph nodes,which mostly showed multiple hypermetabolic enlarged lymph nodes in the abdomen and the neck with uniform density and some fusion into clusters.The difference in Ki-67 index between high and low level groups was statistically significant(t=4.621,P<0.05),and the critical value of Ki-67 index was 35%using ROC curve.There were statistically significant differences in SUV_(max),TBR between the high and low-level groups(t=2.481,t=2.514,P<0.05),with ROC curve critical values of 12.3 and 4.7,respectively,and no statistically significant differences in D_(max)(t=1.380,P>0.05).There was no statistically significant difference in SUV_(max)and TBR between the limited stage group and the disseminated stage group(t=0.534,1.212,P>0.05).Conclusion:Baseline^(18)F-FDG PET/CT imaging of FL mostly showed multiple enlarged lymph nodes in the abdomen and neck with homogeneous and fused masses and different degrees of increased metabolic activity.Baseline^(18)F-FDG PET/CT was effective in assessing the grading

关 键 词：滤泡性淋巴瘤 正电子发射型体层摄影术/X线计算机体层摄影术 18氟脱氧葡萄糖 分期 

分 类 号：R733.4[医药卫生—肿瘤]