RECIL 2017在弥漫大B细胞淋巴瘤患者化疗结束后预后评估中的价值  

The value of RECIL 2017 in evaluating the prognosis of patients with diffuse large B-cell lymphoma after chemotherapy

作　　者：赵剑强 赵新明[1] 韩静雅[1] 敬凤连 马拓 华宇 王彬[1] Zhao Jianqiang;Zhao Xinming;Han Jingya;Jing Fenglian;Ma Tuo;Hua Yu;Wang Bin(Department of Nuclear Medicine and Molecular Imaging,the Fourth Hospital of Hebei Medical University,Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug Resistance,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院核医学与分子影像科,河北省肿瘤微环境与耐药重点实验室,石家庄050011

出　　处：《国际放射医学核医学杂志》2024年第3期168-176,共9页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的探讨淋巴瘤反应评估标准(RECIL)2017在弥漫大B细胞淋巴瘤(DLBCL)患者化疗结束后预后评估中的价值。方法回顾性分析2013年8月至2021年8月于河北医科大学第四医院诊治的108例DLBCL患者的影像资料及临床资料,其中男性49例、女性59例,年龄(49.5±17.0)岁。所有患者均在化疗结束后使用2种PET/CT显像仪行^(18)F-氟脱氧葡萄糖(FDG)PET/CT显像。根据RECIL 2017对患者进行疗效评价,将患者分为完全缓解(CR)、部分缓解(PR)、轻微缓解(MR)、疾病稳定(SD)、疾病进展(PD),随访分析患者化疗后1、3、5年的无进展生存(PFS)率和总生存(OS)率。^(18)F-FDG PET/CT参数及临床资料的比较采用χ2检验或Mann-Whitney U检验。采用单因素分析和多因素Cox比例风险回归分析筛选DLBCL患者化疗后5年PFS率和OS率的影响因素;采用Kruskal-Wallis检验比较不同疗效患者的PFS期和OS期;采用Kaplan-Meier生存曲线分析比较RECIL 2017与Lugano标准第1、3、5年PFS率和OS率的差异;并采用Log-rank检验分析RECIL 2017不同疗效患者的组间差异;采用Kappa检验评估RECIL 2017与Lugano标准的一致性;采用Mann-Whitney U检验比较2种PET/CT显像仪显示的化疗前后靶病灶长径总和(SLD)的差异。结果所有患者的中位随访时间为41.4(31.5,54.1)个月。108例患者的1年PFS率和OS率分别为89.8%(97/108)和100%(108/108);3年PFS率和OS率分别为64.8%(70/108)和84.3%(91/108);5年PFS率和OS率分别为63.0%(68/108)和74.1%(80/108)。108例患者中,CR 52例、PR 13例、MR 11例、SD 12例、PD 20例。单因素分析结果显示,东部肿瘤协作组体能状态评分和国际预后指数是DLBCL患者5年PFS率和OS率的影响因素(χ2=4.592~10.763,均P<0.05)。多因素Cox比例风险回归分析显示,RECIL 2017是DLBCL患者化疗结束后5年PFS率[相对危险度(RR)=1.582,95%CI:1.268~1.972,P<0.001]和5年OS率的影响因素(RR=1.683,95%CI:1.282~2.210,P<0.001)。依据RECIL 2017,在化疗结束后第1、3和5年Objective To evaluate the prognostic value of response evaluation criteria in lymphoma(RECIL)2017 in patients with diffuse large B-cell lymphoma(DLBCL).Methods The imaging data and clinical data of 108 patients with DLBCL treated in the Fourth Hospital of Hebei Medical University from August 2013 to August 2021 were analyzed retrospectively,including 49 males and 59 females,aged(49.5±17.0)years.All patients underwent^(18)F-fluorodeoxyglucose(FDG)PET/CT imaging using two kinds of PET/CT scanner after chemotherapy.In accordance with RECIL 2017,the patients were divided into complete response(CR),partial response(PR),minor response(MR),stable disease(SD),and progressive disease(PD).The progression-free survival(PFS)rate and overall survival(OS)rate of the patients at 1,3,and 5 years after chemotherapy were analyzed by follow-up analysis.Pearson's chi-squared test and Mann-Whitney U test were applied in the comparision of^(18)F-FDG PET/CT parameters and clinical data.Univariate analysis and multivariate Cox proportional risk regression analysis were used to screen the influencing factors of 5-year PFS and OS rates after chemotherapy in patients with DLBCL.Kruskal-Wallis test was used to compare the PFS and OS time among patients with different therapeutic effects.Kaplan-Meier survival curve was used to assess the differences in PFS and OS rates between RECIL 2017 and Lugano standards at 1,3,and 5 years.Logrank test was used to analyze the differences in patients with different therapeutic effects evaluated by RECIL 2017.Kappa test was used to evaluate the consistency between RECIL 2017 and Lugano standard,and Mann-Whitney U test was used to compare the differences in sum of longest diameters(SLD)of target lesions shown by two kinds of PET/CT imaging before and after chemotherapy.Results The median follow-up time for all patients was 41.4(31.5,54.1)months.The 1-year PFS and OS rates were 89.8%(97/108)and 100%(108/108);the 3-year PFS and OS rates were 64.8%(70/108)and 84.3%(91/108),respectively;and the 5-year PFS and

关 键 词：淋巴瘤 大B细胞 弥漫性 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 预后 淋巴瘤反应评估标准 Lugano标准 

分 类 号：R733.1[医药卫生—肿瘤]