^(18)F-FDG PET/CT代谢参数辅助评估弥漫大B细胞淋巴瘤化疗疗效  

The study on the assistance of ^(18)F-FDG PET/CT metabolic parameters in evaluating the therapeutic efficacy of chemotherapy in diffuse large B-cell lymphoma

作　　者：翁翔 赵明哲[1] 姜婷 胡慧仙[1] Weng Xiang

机构地区：[1]浙江大学附属医院金华医院,321000

出　　处：《浙江临床医学》2024年第2期166-168,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省金华市公益性技术应用研究项目(2022-4-094)。

摘　　要：目的探讨^(18)F-FDG PET/CT代谢参数与弥漫大B细胞淋巴瘤(DLBCL)化疗疗效的相关性。方法回顾性总结2021年2月至2023年2月本院确诊DLBCL患者共78例,采用R-CHOP化疗方案。治疗前采用^(18)F-FDG PET/CT测量代谢参数包括标准摄取值的最大值(SUVmax)、峰值(SUVpeak)和平均值(SUVmean)、肿瘤代谢体积(MTV)和糖酵解总量(TLG),解剖学参数包括肿瘤位置、最大直径和AnnArbor分期。治疗4个疗程(21 d为1个疗程)后复查PET/CT,根据Lugano修订淋巴瘤疗效评价标准分为有效组62例和无效组16例,比较两组PET/CT参数。结果与无效组比较,有效组年龄和最大直径较小,改良国际预后指数(NCCN-IPI)和乳酸脱氢酶(LDH)水平较低,Ⅲ~Ⅳ期和骨髓侵犯较少;SUVmax、MTV和TLG值降低(P<0.05)。Spearman检验显示,SUVmax、MTV和TLG值与最大直径、NCCNIPI、LDH和AnnArbor分期呈显著正相关(P<0.05)。ROC计算SUVmax、MTV和TLG值预测DLBCL患者化疗疗效的AUC为0.741、0.886和0.869(P<0.001),MTV和TLG明显优于SUVmax(P<0.001),但MTV和TLG无明显差异(P>0.05)。结论^(18)F-FDG PET/CT作为DLBCL临床分期、疗效评估和预后随访的重要方法,代谢参数MTV和TLG值与化疗疗效密切相关。Objective To explore the relationship of ^(18)F-fluorodeoxyglucose(^(18)F-FDG)PET/CT metabolic parameters and the chemotherapy efficacy of diffuse large B-cell lymphoma(DLBCL).Methods 78 patients with DLBCL in our hospital from February 2021 to February 2023 were retrospectively summarized,using the first-line R-CHOP chemotherapy regimen.Before treatment,metabolic parameters were measured using ^(18)F-FDG PET/CT,including maximum(SUVmax),peak(SUVpeak),and mean(SUVmean)of standard uptake value,metabolic tumor volume(MTV),and total lesion glycolysis(TLG).Anatomic parameters included tumor location,maximum diameter,and AnArbor staging.After 4 courses of treatment(21 days as 1 course),PET/CT was re examined.They were divided into the effective group of 62 cases and the ineffective group of 16 cases according to Lugano's revised lymphoma efficacy evaluation criteria.The PET/CT parameters were compared.Results Compared with the ineffective group,the effective group had smaller age and maximum diameter,lower levels of National Comprehensive Cancer Network International Prognostic Index(NCCN-IPI)and lactate dehydrogenase(LDH),fewer Ⅲ-Ⅳ stages and bone marrow invasions,the SUVmax,MTV,and TLG decreased,(P<0.05).Spearman test showed that SUVmax,MTV,and TLG values were significantly positively correlated with maximum diameter,NCCN-IPI,LDH,and AnArbor staging(P<0.05).The receiver operating curve(ROC)showed that the AUC values of SUVmax,MTV,and TLG predicting the chemotherapy efficacy of DLBCL patients were 0.741,0.886,and 0.869,respectively(P<0.001).MTV and TLG were significantly better than SUVmax(P<0.001),but there was no difference between MTV and TLG(P>0.05).Conclusion ^(18)F-FDG PET/CT is an important method for clinical staging,efficacy evaluation,and prognosis follow-up of DLBCL.The metabolic parameters MTV and TLG values are closely related to chemotherapy efficacy.

关 键 词：弥漫大B细胞淋巴瘤 化疗 PET/CT 标准摄取值 肿瘤代谢体积 糖酵解总量 乳酸脱氢酶 

分 类 号：R733.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学]