18 F-FDG PET/CT显像在评价不同病理亚型淋巴瘤疗效方面的价值

目的：探讨18 F-脱氧葡萄糖(18 F-FDG) PET/CT在不同病理亚型淋巴瘤疗效的评估价值。方法收集我科近4年来治疗前后均行PET/CT检查的淋巴瘤患者资料，同时根据自愿原则随机选取治疗前已行PET/CT检查的淋巴瘤患者，于治疗2~4个疗程后再次行PET/CT检查。回顾性分析并比较43例不同病理亚型淋巴瘤病灶(包括淋巴结病灶和结外灶)治疗前最大标准摄取值( SUVmax )、滞留指数( RI)和治疗后的SUVmax并进行统计学分析。所有病例随访至少3个月。结果治疗前霍奇金淋巴瘤( HL)与非霍奇金淋巴瘤( NHL)的病灶间平均SUVmax比较及RI比较差异无统计学意义。治疗前不同病理亚型的NHL淋巴瘤病灶平均SUVmax及RI与NHL的侵袭性呈正相关性，与淋巴瘤的分期无明显相关；治疗后43例患者达到完全缓解23例，部分缓解16例，疾病稳定状态1例，复发或进展3例。治疗前后淋巴瘤病灶的SUVmax差异有统计学意义(P<0．01)。结论18 F-FDG PET/CT显像对淋巴瘤患者治疗前后病灶平均SUVmax及RI的比较分析能有效评价疗效、判断预后，并为进一步治疗方案制定提供帮助和指导。

Significance of 18 F-FDG PET/CT imaging in evaluating curative effect of different pathologic subtypes of lymphoma

Objective The purpose of this study was to identify the roles of 18 F-FDG PET/CT imaging in evaluating the therapeutic efficacy of lymphoma with different pathologic subtypes. Methods Patients with lymphoma who had received PET/CT check in pre-therapy and post-therapy for nearly four years were recruited in this study. Patients with lymphoma who had received such checks before treatment were also randomly selected voluntarily, and another PET/CT imaging was performed on them after 2~4 courses of treatment. Finally, the pre-therapy and post-treat-ment maximumstandardized uptake value ( SUVmax) or retention index ( RI) of 43 lymphoma lesions with different subtypes ( including the lymph gland lesion and the extranodal lesion) were analyzed, comparing both retrospective-ly and statistically. In addition, all patients received a follow-up at least 3 months. Results By comparison, there was no significant difference in the RI and the average SUVmax between Hodgkin lymphoma ( HL ) lesions and Non-Hodgkin lymphoma ( NHL) lesions before treatment. Besides, the RI and the average SUVmax of NHL lym-phoma lesions with different subtypes had a positive relation to NHL invasiveness before treatment. However, no obvious relation existed between the RI and the average SUVmax of NHL lymphoma lesions and the periodization of lymphoma. After treatment, 23 of the 43 patients showed complete remission, 16 patients showed partial remission, 1 patient had stable disease, and 3 had relapsed disease/progressive disease. In a word, the SUVmax differences of lymphoma lesions before and after the treatment had significant statistical significance ( P<0. 01 ) . Conclusion With regard to the comparative analysis of average SUVmax and RI before and after lymphoma lesion treatment, 18 F-FDG PET/CT imaging can evaluate the curative effects and prognosticate diseases effectively,and provide assis-tance and guidance for the formulation of a further therapeutic schedule as well.