^(18)F-FDG PET/CT扩散参数联合肿瘤代谢体积评估弥漫大B细胞淋巴瘤患者预后  

^(18)F-FDG PET/CT dissemination parameters combined with metabolic tumor volume for evaluating prognosis of diffuse large B-cell lymphoma patients

作　　者：李佳苗 曹小梅 李冬菊 马小伟 王蓉[1] 王莹[1] 杨吉琴[1] LI Jiamiao;CAO Xiaomei;LI Dongju;MA Xiaowei;WANG Rong;WANG Ying;YANG Jiqin(Department of Nuclear Medicine,General Hospital of Ningxia Medical University,Yinchuan 750000,China;College of Clinical Medicine,Ningxia Medical University,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学总医院核医学科,宁夏银川750000 [2]宁夏医科大学研究生院,宁夏银川750000

出　　处：《中国医学影像技术》2023年第9期1359-1363,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察^(18)F-FDG PET/CT扩散参数联合肿瘤代谢体积(MTV)评估弥漫大B细胞淋巴瘤(DLBCL)患者预后的价值。方法回顾分析98例DLBCL患者治疗前临床及PET/CT资料,测量病灶代谢及扩散参数,包括最大标准摄取值、MTV、病灶糖酵解总量、相离最远2个病灶间距(Dmax_(patient))、全身最大病灶与其相离最远病灶间距(Dmax_(bulk))、全身最大病灶与其他所有病灶间距的总和(SPREAD_(bulk))及全身所有病灶与其他所有病灶间距的总和(SPREAD_(patient))。绘制受试者工作特征曲线,评价各参数预测预后的效能;以Kaplan-Meier法行生存分析,以Cox回归模型筛选预后独立影响因素。结果98例DLBCL中位随访时间为23.7(11,35)个月,中位无进展生存期(PFS)为17.2(8,24)个月。MTV和Dmax_(patient)分别为评估PFS效能的最佳代谢及扩散参数,截断值分别取347.00 cm^(3)和50.10 cm时,曲线下面积分别为0.69和0.67。乳酸脱氢酶、东部肿瘤协作组评分、MTV、Dmax_(patient)和SPREAD_(bulk)均为PFS独立影响因素(风险比=3.16、2.95、1.81、3.22、1.18,P均<0.05)。以Dmax_(patient)≥50.10 cm与MTV≥347.00 cm^(3)作为危险因素将患者分为高、中及低危组(分别具有2、1及0个危险因素),其2年无进展生存率分别为44.73%、57.14%及84.00%,高、中危组2年无进展生存率明显低于低危组(P均<0.01)。结论^(18)F-FDG PET/CT扩散参数Dmax_(patient)联合MTV可早期对DLBCL患者进行危险分层。Objective To observe the value of^(18)F-FDG PET/CT dissemination parameters combined with metabolic tumor volume(MTV)for evaluating prognosis of patients with diffuse large B-cell lymphoma(DLBCL).Methods Pre-treatment clinical data and PET/CT data of 98 DLBCL patients were retrospectively analyzed.The metabolic parameters and dissemination parameters of the lesions were measured,including the maximum standard uptake value,MTV and total lesion glycolysis,as well as the distance between 2 furthest apart from lesions(Dmax_(patient)),between the largest lesion and the lesion furthest from that bulk,the sum of the distances from the largest lesion to all other lesions(SPREAD bulk),also the sum of distances from each lesion to all the other lesions.The receiver operating characteristic curve was drawn to evaluate the predictive efficacy of each parameter for predicting prognosis.Survival analysis was performed using Kaplan-Meier method.Cox regression model was used to conduct multivariate analysis to screen independent impact factors of prognosis.Results The median follow-up time was 23.7(11,35)months,and the median progression-free survival(PFS)was 17.2(8,24)months.MTV and Dmax_(patient)was the best metabolic and dissemination parameter for evaluating PFS,respectively.Taken 347.00 cm^(3)and 50.10 cm as the cut-off value,the area under the curve of MTV and Dmax_(patient)was 0.69 and 0.67,respectively.The level of lactate dehydrogenase,Eastern Cooperative Oncology Group score,MTV,Dmax_(patient)and SPREAD bulk were all the independent impact factors of PFS(hazard ratio=3.16,2.95,1.81,3.22,1.^(18),all P<0.05).Taken Dmax_(patient)≥50.10 cm and MTV≥347.00 cm^(3)as risk factors,the patients were divided into high,medium and low risk groups(with 2,1 and 0 risk factors,respectively)groups,and the 2-year progression-free survival rate of high,medium and low risk group was 44.73%,57.14%and 84.00%,respectively,of high-risk group and intermediate-risk group were significantly lower than of low-risk group(both P<0.01).Conclusio

关 键 词：淋巴瘤 大B细胞 弥漫性 正电子发射断层显像 体层摄影术 X线计算机 18F氟脱氧葡萄糖 

分 类 号：R733[医药卫生—肿瘤] R817.4[医药卫生—临床医学]