氟脱氧葡萄糖PET/CT在原发性胃肠道淋巴瘤化疗中期预后评估中的价值  

Prognostic value of^(18)F-fluorodeoxyglucose PET/CT during interim chemotherapy for primary gastrointestinal lymphoma

作　　者：郑立春[1] 张欢 顾程 刘丽云[3] 张晓明[1] 欧阳向柳 ZHENG Lichun;ZHANG Huan;GU Cheng;LIU Liyun;ZHANG Xiaoming;OUYANG Xiangliu(Department of Nuclear Medicine,Tangshan Gongren Hospital,Tangshan 063000,China;Graduate School,North China University of Science and Technology,Tangshan 063210,China;Department of Pathology,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Ultrasound,Tangshan Gongren Hospital,Tangshan 063000,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063210 [3]唐山市工人医院病理科,河北唐山063000 [4]唐山市工人医院超声医学科,河北唐山063000

出　　处：《中国医科大学学报》2023年第9期823-827,共5页Journal of China Medical University

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

摘　　要：目的探讨氟脱氧葡萄糖(^(18)F-FDG)PET/CT显像Deauville评分和最大标准化摄取值的变化值(ΔSUV_(max))在原发性胃肠道淋巴瘤(PGIL)化疗中期预后评估中的价值。方法回顾性分析2012年1月至2019年12月于唐山市工人医院就诊的54例PGIL化疗中期^(18)F-FDG PET/CT资料,对ΔSUV_(max)、ΔSUV_(max)%进行受试者操作特征(ROC)曲线分析,分别对ΔSUV_(max)及ΔSUV_(max)%最佳界值、Deauville评分分组,采用Kaplan-Meier生存曲线和Cox回归分析其预后评估能力及相关性。结果54例患者中,进展组21例,未进展组33例,2组ΔSUV_(max)均值差异有统计学意义(5.37±4.19 vs 8.14±5.29,t=2.134,P=0.038),2组ΔSUV_(max)%中位数差异有统计学意义(44.12%vs 73.53%),Z=-3.380,P=0.001)。ΔSUV_(max)及ΔSUV_(max)%曲线AUC分别为0.651(95%CI:0.502~0.800,P=0.064)、0.775(95%CI:0.641~0.909,P=0.001),分别以界值10.35、64.86%分组,Kaplan-Meier显示3年无进展生存(PFS)(52.4%vs 91.7%、36.4%vs 78.1%)差异均有统计学意义(P均<0.01)。Deauville<4分(PET阴性)组与和Deauville≥4分(PET阳性)组3年PFS差异有统计学意义(92.0%vs 34.5%,P<0.01)。Deauville评分与ΔSUV_(max)及ΔSUV_(max)%呈负相关(P<0.05)。Cox多因素分析结果显示,Deauville评分及ΔSUV_(max)为独立预测因素(P<0.05)。结论Deauville评分法和ΔSUV_(max)法在PGIL化疗中期预后评估均有较高价值,Deauville评分及ΔSUV_(max)为PFS的独立预测因素。Objective To evaluate the prognostic value of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)PET/CT Deauville score and the change in the maximum standardized uptake value(ΔSUV_(max))during interim chemotherapy for primary gastrointestinal lymphoma(PGIL).Methods ^(18)F-FDG PET/CT results of fifty-four patients with PGIL undergoing interim chemotherapy in Tangshan Gongren Hospital from January 2012 to December 2019 were collected for this retrospective analysis.A receiver operating characteristic(ROC)curve was used to estimate the optimal cutoff value of theΔSUV_(max),ΔSUV_(max)%,and Deauville score.Kaplan-Meier curve and Cox regression analysis were used to determine the prognostic value of these indictors.Results There was disease progression in twenty-one of the fifty-four patients,and thirty-three did not experience disease progression.The difference of means of theΔSUV_(max)between the two groups was statistically significant(5.37±4.19 vs 8.14±5.29,P<0.05).The difference of medians of theΔSUV_(max)%between the two groups was statistically significant(44.12%vs 73.53%,P<0.05).The AUC of the ROC curve for theΔSUV_(max)andΔSUV_(max)%were 0.651(P=0.064)and 0.775(P=0.001),respectively.The cutoff of theΔSUV_(max)andΔSUV_(max)%were 10.35 and 64.86%,respectively.Kaplan-Meier analysis showed that the difference in the three-year PFS between the lower and higherΔSUV_(max)(52.4%vs 91.7%)and between the lower and higherΔSUV_(max)%(36.4%vs 78.1%)were statistically significant(P<0.01).The difference in the three-year PFS between Deauville score<4(PET negative)and Deauville score≥4(PET positive)was statistically significant(92.0%vs 34.5%,P<0.01).Deauville score was negatively correlated with theΔSUV_(max)andΔSUV_(max)%.The multivariate Cox analysis results showed that Deauville score andΔSUV_(max)were significant prognostic factors for PFS.Conclusion Deauville score and theΔSUV_(max)have high prognostic value during interim chemotherapy for PGIL.Deauville score and theΔSUV_(max)were the significant prognostic facto

关 键 词：淋巴瘤 胃肠道 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖 

分 类 号：R445.6[医药卫生—影像医学与核医学] R817.4[医药卫生—诊断学]