化疗中期及终末期18F—FDGPET／CT显像对弥漫性大B细胞淋巴瘤患者预后评估价值

目的探讨化疗中期及终末期18F-FDGPET／CT显像对DLBCL患者预后评估的价值。方法回顾性分析2005年至2011年经手术或活组织病理检查确诊的110例（男62例，女48例，中位年龄52岁）DLBCL患者的18F—FDGPET／CT显像结果。其中在化疗中期（4周期）、化疗终末期（6∽8周期）、化疗中期＋终末期行PET／CT检查的患者分别为42、44和24例。根据显像结果将患者分为阳性组和阴性组，以无进展生存（PFS）期及总体生存（os）期为评价指标，对各组患者进行预后评估。组间PFS率及Os率的比较采用疋。检验，预后因素分析采用Kaplan—Meier生存分析法。结果化疗中期”F—FDGPET／CT显像阳性组28例，阴性组38例，2组中位PFS期分别为20和37个月，3年PFS率分别为17．9％（5／28）和52．6％（20／38），差异有统计学意义（χ2=8．285，P〈O．01）；中位Os期分别为28和39个月，3年0s率分别为35．7％（10／28）和55．3％（21／38），差异无统计学意义（χ2=2．473，P〉0．05）。化疗终末期”F．FDGPET／CT显像阳性组20例，阴性组48例，2组中位PFS期分别为21和54个月，3年PFS率分别为20．O％（4／20）和77．1％（37／48），差异有统计学意义（χ2=19．215，P〈0．01）；中位Os期分别为26和57个月，3年0s率分别为25．0％（5／20）和83．3％（40／48），差异有统计学意义（χ2=21．462，P〈0．01）。结论化疗终末期PET／CT是DLBCL患者预后评估的可靠方法，而化疗中期PET／CT对患者的预后评估有一定的局限性。

Prognostic value of interim and post-therapy lSF-FDG PET/CT in patients with diffuse large B-cell lymphoma

Objective To investigate the prognostic value of interim and post-therapy 18F-FDG PET/CT in patients with DLBCL. Methods A retrospective analysis was conducted in 110 patients （62 males, 48 females; median age 52 years） with newly diagnosed DLBCL. Forty-two patients underwent inter- im PET/CT after 4 cycles chemotherapy, 44 patients underwent post-therapy PET/CT after 6-8 cycles of chemotherapy, and 24 patients underwent both interim PET/CT and post-therapy PET/CT. Interim and post-therapy PET/CT status （i.e., positive or negative） were visually interpreted according to criteria of the International Harmonization Project. Three-year progression-free survival （PFS） and 3-year overall survival （OS） was compared between the subjects with positive or negative PET/CT results. χ2 test and Kaplan- Meier analysis were used for data analysis. Results Interim SF-FDG PET/CT results were positive in 28 cases and negative in 38 cases. The median PFS and OS were 20 and 28 months in patients with positive scan results, those were 37 and 39 months in patients with negative results, respectively. Three-year PFS and 3-year OS rates were 17.9% （5/28） and 35.7% （10/28） in patients with positive interim PET/CT resuits, those were 52.6% （20/38） and 55.3% （21/38） in patients with negative results （χ2 = 8. 285, P〈 0.01, χ2= 2.473, P〉0.05, respectively）. Post-therapy lSF-FDG PET/CT results were positive in 20 cases and negative in 48 cases. Median PFS and OS were 21 and 26 months in patients with positive results, those were 54 and 57 months in patients with negative results. Three-year PFS and 3-year OS rates were 20.0% （4/20） and 25.0%（5/20） in patients with positive results at post-therapy PET/CT, those were 77.1% （37/48） and 83.3% （40/48） in patients with negative results （χ2 = 19.215, 21.462, both P〈0.01）. Con- clusions Post-therapy 18F-FDG PET/CT is useful to predict prognosis of patients with DLBCL. However, the value of interim PET/CT may be limited in terms of pro