基线18F-FDG PET／CT最大标准摄取值与B细胞非霍奇金淋巴瘤临床疗效及预后的关系

目的 评估18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像/电子计算机断层扫描(¹⁸F-flurodeoxyglucose positron emission tomography/computed tomography,¹⁸F-FDG PET/CT)的最大标准化摄取值(maximum standard uptake value, SUV_max)与B细胞非霍奇金淋巴瘤的疗效及预后的关系。方法 分析2016年8月至2019年9月于首都医科大学附属北京世纪坛医院收治的初治弥漫大B细胞淋巴瘤及滤泡性淋巴瘤患者共47例,评估基线SUV_max与各临床病理因素、实验室化验指标之间的相关性,用受试者工作特征(receiver operating characteristic, ROC)曲线分析法确定基线SUV_max对疾病进展的最佳临界点,分析其对治疗疗效及生存的预后、预测价值。结果 ①乳酸脱氢酶(lactic dehydrogenase,LDH)浓度、1年内有无进展、病理类型组别中的基线SUV_max均值差异有统计学意义;②以1年进展率为截点,ROC曲线上SUV_max最佳临界点为14.4,以14.4为界限值进行分组,发现SUV_max＜14.4组患者中位无进展生存时间(progression-free survival, PFS)、中位总生存期(overall survival, OS)均远远高于SUV_max≥14.4组;③以随访结束后患者疾病进展为截点,SUV_max最佳临界点为16.7,以16.7为界限值进行分组,发现SUV_max＜16.7组患者中位PFS远高于SUV_max≥16.7组(P=0.025)。结论 B细胞型非霍奇金淋巴瘤患者的基线SUV_max与疗效及生存预后有密切关系,具有很大的临床应用价值。

The efficacy and prognostic value of maximum standard uptake on baseline 18 F-FDG PET/CT in B-cell non-Hodgkin's lymphoma

Objective To evaluate the efficacy and prognostic value of maximum standardized uptake (SUV_max) of ¹⁸F-flurodeoxyglucose positron emission tomography/computed tomography(¹⁸F-FDG PET/CT) in B-cell non-Hodgkin's lymphoma (NHL). Methods A total of 47 patients with B-cell non-Hodgkin's lymphoma treated in Beijing Shijitan Hospital, Capital Medical University from August 2016 to September 2019 were retrospectively analyzed. The correlation between baseline SUV_max and clinicopathological factors, laboratory indexes was evaluated. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal point of SUV_max for disease progression, and the prognostic value of SUV_max was analyzed. Results ①There were significant differences between the baseline SUV_max and lactic dehydrogenase(LDH) level, progression status within 1 year, pathological types, respectively; ②Take the 1-year progression rate as the cut-off point, the optimal point of SUV_max was 14.4, the median progression-free survival (PFS) and overall survival (OS) of patients with SUV_max＜14.4 were significantly higher than those with SUV_max≥14.4,P<0.05; ③Take the disease progression as the cut-off point, the optimal pointof SUV_max was 16.7, the median PFS of patients with SUV_max＜16.7 were significantly higher than those with SUV_max≥16.7,P=0.025. Conclusion Baseline SUV_max of patients with B-cell lymphoma is closely related to the curative effect and survival, which has great clinical value.