眼附属器淋巴瘤18F-FDG PET/CT的代谢特征及其与临床分期的相关性

目的 分析眼附属器淋巴瘤(ocular adnexal lymphomas,OAL) 氟-18-脱氧葡萄糖( ¹⁸F-fluorodeoxyglucose, ¹⁸F-FDG)正电子发射型计算机断层扫描显像(positron emission tomography/computed tomography, PET/CT)的代谢参数与临床分期之间的关系,并比较不同病理类型OAL之间代谢参数的差异。方法 将2012年4月至2020年4月在解放军总医院第一医学中心核医学科行¹⁸F-FDG PET/CT检查并由病理诊断为OAL的患者为研究对象。分别记录病灶最大标准化摄取值(maximum standardized uptake value,SUVmax)、平均标准化摄取值(average standardized uptake value,SUVmean)、代谢体积(metabolic tumor volume,MTV)与病灶糖酵解总量(total lesion glycolysis lesion,TLG)。以¹⁸F-FDG PET/CT结果及患者临床资料进行Ann Arbor分期。根据主要病理类型进行分组,比较各组代谢参数的差异,并比较所有病例各代谢参数与不同分期的相关性。结果 共计37名初发OAL患者纳入研究。病理分型以黏膜相关淋巴组织结外边缘区 B 细胞淋巴瘤(extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, MALT, n=13)、弥漫大 B 细胞淋巴瘤(diffuse large B-cell lymphoma, DLBCL, n=12)和结外NK/T细胞淋巴瘤,鼻型(extranodal natural killer/T-cell lymphoma, nasal type, ENK-TCL, n=7)为主。通过比较上述3组患者各项代谢参数后发现,DLBCL、 ENK-TCL与MALT之间各项代谢参数差异均具有统计学意义(P＜0.01)。在所有37例患者中,不同分期的代谢参数中SUVmax和TLG差异存在统计学意义(P＜0.05)。 各项代谢参数均与疾病分期呈正相关, 其中TLG与MTV的相关性较SUV_max及SUV_mean更强。结论 ¹⁸F-FDG PET/CT各项代谢参数与临床分期具有相关性,其中TLG与MTV与临床分期的相关性更强。

Correlation between metabolic characteristics of ocular adnexal lymphoma manifested by ~(18)F-FDG PET/CT and its clinical stage

Objective To analyze the relationship between the metabolic parameters of ocular adnexal lymphoma (OAL) by ¹⁸F-fluorodeoxyglucose(¹⁸F-FDG) positron emission tomography/computed tomography(PET/CT) and its clinical stage, and compare the differences of metabolic parameters between different pathological types of OAL.Methods A total of 37 patients who underwent ¹⁸F-FDG PET/CT in the Department of Nuclear Medicine of the First Medical Center of PLA General Hospital from April 2012 to April 2020 and was diagnosed as OAL by pathology were enrolled. The maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis lesion (TLG) were retrospectively analyzed, respectively. Ann Arbor classification was based on PET/CT results and clinical data. The patients were grouped according to main pathological types, and the differences in the metabolic parameters between the groups were compared to each other to explore the correlations between the metabolic parameters and different stages. Results The pathological classification was mainly B-cell lymphoma in the extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT, n=13), diffuse large B-cell lymphoma (DLBCL, n=12) and extranodal natural killer/T-cell lymphoma, nasal type (ENK-TCL, n=7). By comparing the metabolic parameters of the above three groups, the differences of metabolic parameters between DLBCL, ENK-TCL and MALT were statistically significant (P<0.01). In all 37 patients, there were significant differences in SUVmax and TLG among different stages (P<0.05), and the metabolic parameters were positively correlated with disease stages, and the correlation between TLG and MTV were stronger than that between SUVmax and SUVmean. Conclusion The metabolic parameters manifested by ¹⁸F-FDG PET/CT were correlated with clinical stage, especially TLG and MTV.