RECIL对NHL患者自体造血干细胞移植后的预后评估及与Lugano标准的对比研究  

Prognostic evaluation of NHL patients after autologous hematopoietic stem cell transplantation using RECIL and comparative study with Lugano standard

作　　者：于青青 赵铭[1] 田蓉蓉[1] 原凌[1] 林艳梅 王晋波 贾媛 Yu Qingqing;Zhao Ming;Tian Rongrong;Yuan Ling;Lin Yanmei;Wang Jinbo;Jia Yuan(Department of Nuclear Medicine,Shanxi Provincial Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院,中国医学科学院肿瘤医院山西医院,山西医科大学附属肿瘤医院核医学科,太原030013

出　　处：《国际放射医学核医学杂志》2023年第11期659-667,共9页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：山西省卫健委一般项目(201301092)。

摘　　要：目的探讨自体造血干细胞移植(ASCT)后18F-氟脱氧葡萄糖(FDG)PET/CT显像淋巴瘤疗效评价标准(RECIL)对非霍奇金淋巴瘤(NHL)患者预后评估的价值并与Lugano标准进行对比研究。方法回顾性分析2010年10月至2021年11月于山西省肿瘤医院经组织病理学检查结果确诊的86例NHL患者的临床资料和影像资料,其中男性63例、女性23例,年龄34.0(22.0,47.0)岁。所有患者均在ASCT前后行18F-FDG PET/CT显像。根据RECIL在ASCT后对所有患者进行疗效评价,依据患者疗效评价结果将患者分为有效组:完全缓解(CR)、部分缓解(PR)、轻微缓解(MiR);无效组:疾病稳定(SD)、疾病进展(PD)。依据Lugano标准在ASCT后对所有患者进行疗效评价,将患者分为完全缓解组(CR)、部分缓解组(PR)、无效组(SD+PD);依据RECIL将患者分为:完全缓解组(CR)、部分缓解组(PR+MiR)、无效组(SD+PD),随访分析患者3年总生存(OS)期情况。采用卡方检验或Mann-Whitney U检验比较有效组和无效组患者的临床特征和18F-FDG PET/CT参数的差异;采用单因素及多因素Cox比例风险回归分析筛选影响ASCT后NHL患者预后的相关因素;采用Kappa检验评价RECIL和Lugano标准评估NHL患者ASCT后疗效的一致性;采用Kaplan-Meier生存分析比较RECIL与Lugano标准完全缓解组、部分缓解组和无效组间3年OS率的差异;采用Log-rank检验分析3组间3年OS率的差异;采用ROC曲线比较RECIL及Lugano标准对NHL患者ASCT后3年OS率的预测效能。结果有效组与无效组患者ASCT后SUVmax[1.3(1.0,2.0)对5.2(4.8,8.9)]的差异有统计学意义(Z=−6.149,P<0.001),有效组移植前化疗方案数<2次的患者占比[65.7%(44/67)]高于无效组[21.1%(4/19)],且差异有统计学意义(χ^(2)=11.949,P<0.001);有效组一线巩固治疗组的患者占比[83.6%(56/67)]高于无效组[31.6%(6/19)],差异有统计学意义(χ^(2)=19.897,P<0.001)。单因素Cox比例风险回归分析结果显示,RECIL(HR=0.020,95%CI:0.003~0.155,P<0.001)�Objective To explore the prognostic evaluation of the 18F-FDG PET/CT imaging response evaluation criteria in lymphoma(RECIL)for patients with non-Hodgkin's lymphoma(NHL)after autologous hematopoietic stem cell transplantation(ASCT)and compares it with the Lugano standard.Methods The clinical data and imaging data of 86 patients with NHL diagnosed by histopathological examination in Shanxi Provincial Cancer Hospital from October 2010 to November 2021 were retrospectively analyzed,including 63 male and 23 female,aged 34.0(22.0,47.0)years old.All patients underwent 18F-FDG PET/CT imaging before and after ASCT.According to the RECIL,all patients were evaluated for efficacy after ASCT.Based on the results of the patient efficacy evaluation,patients were divided into effective groups:complete remission(CR),partial remission(PR),and minor remission(MiR),and invalid groups:stable disease(SD),and progressive disease(PD).According to the Lugano standard,the patients were divided into complete remission group(CR),partial remission group(PR),and ineffective group(SD+PD).According to the RECIL,the patients were divided into complete remission group(CR),partial remission group(PR+MiR),andineffective group(SD+PD).The three-year overall survival(OS)period of the patients was followed up and analyzed.Pearson Chisquared test and Mann Whitney U test were used to compare the differences in clinical features and the 18F-FDG PET/CT parameters between the effective group and the ineffective group.Univariate and multivariate Cox proportional risk regression analysis were used to screen for relevant factors affecting the prognosis of patients with NHL after ASCT.Kappa test was used to evaluate the consistency of efficacy between the RECIL and Lugano standard in evaluating the efficacy of ASCT in patients with NHL.Kaplan-Meier survival analysis was used to compare the differences in three-year OS rates between RECIL and Lugano standard in complete remission,partial remission,and ineffective groups.Log rank test was used to analyze the dif

关 键 词：淋巴瘤 非霍奇金 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算机 自体造血干细胞移植 RECIL Lugnao标准 

分 类 号：R457.7[医药卫生—治疗学] R733.1[医药卫生—临床医学]