FDGPET/CT对淋巴瘤化疗后结外淋巴组织及残存淋巴结病灶的应用价值  

Application Value of FDG PET-CT in Evaluation of Lymphoid Tissues and Residual Soft-tissue Mass in Malignant Lymphoma After Chemotherapy

作　　者：王剑杰[1] 蒲朝煜[1] 梁英魁[2] 

机构地区：[1]武警总医院核医学科,100039 [2]海军总医院核医学科,100037

出　　处：《实用癌症杂志》2015年第8期1152-1156,共5页The Practical Journal of Cancer

摘　　要：目的探讨FDG PET/CT对评价淋巴瘤化疗后淋巴组织或残余淋巴结病灶是否有肿瘤存活的准确性。方法经病理活检确诊的淋巴瘤患者36例,接受6个周期的化疗,化疗结束行FDG PET/CT评估疗效,并与同期CT平扫比较,对PET阳性的病灶行病理活检证实,PET阴性者进行6个月以上随访,1年随访期内未出现肿瘤复发判定为完全缓解,以病理和随访结果作为最终评价标准。结果 36例患者中,PET/CT评价其中32例为完全缓解(31例符合最终结果,假阴性1例),4例为部分缓解(4例均与病理结果相符);常规CT平扫提示10例患者化疗后原病灶部位见软组织病灶残存,评价为部分缓解,其中7例PET显像为阴性,3例患者PET呈阳性(3例病理检查证实均存在肿瘤残留);26例评价为完全缓解(25例与随访结果相符,其中假阴性1例)。PET/CT诊断淋巴瘤化疗后残余病变肿瘤残留的灵敏度、特异度和准确度分别为80.0%、100%、97.2%,同期平扫CT分别为75.0%、78.1%、77.7%。结论 FDG PET/CT是判断淋巴瘤化疗后结外淋巴组织及淋巴结内是否有肿瘤残存,较为准确的无创性影像学检查手段,值得临床广泛采用。Objective To study the accuracy of FDG PET-CT in evaluation of lymphoid tissues and residual soft-tissue mass in malignant lymphoma after chemotherapy. Methods 36 patients with pathologically proved lymphoma received 6 cycles of chemotherapy,FDG PET-CT scanning were performed before the treatment and in 6 weeks after chemotherapy,Chemotherapy response was evaluated through FDG PET-CT,compared with the plain CT in corresponding period. All suspectable mass proved by biopsy,All the residual soft-tissue mass without increased of FDG uptake received more than 6 months follow-up by regular CT to verify the final results,the clinical follow-up results and pathology biopsy were set as criteria for final diagnosis. Results Among36 cases,PET-CT showed that 32 patients were complete response( CR),including 1 false negative case,and 4 patients were partial response( PR). 10 patients had residual mass on plain CT,3 of them were positive,the other 7 cases were negative. The diagnostic sensitivity,specificity,accuracy of PET / CT and CT were 80. 0% 、100% 、97. 2%,vs 75. 0% 、78. 1% 、77. 7%,respectively in assessment of residual tumor. Conclusion FDG PET-CT imaging is effective and non-invasive in the differentiation of lymphoid tissues and residual soft-tissue mass in malignant lymphoma after chemotherapy. PET-CT is superior to routine CT in the assessment of chemotheraphy response,it is worthy of clinical application.

关 键 词：淋巴瘤 化疗 正电子发射计算机断层显像 体层摄影术 X线计算机 响应 

分 类 号：R733.1[医药卫生—肿瘤]