18F-FDG PET-CT在弥漫大B细胞淋巴瘤预后判断中的价值

目的 探讨18F-FDG PET-CT在弥漫大B细胞淋巴瘤(DLBCL)预后判断中的价值.方法 回顾性分析2009年6月至2015年5月130例初诊DLBCL患者的临床资料及治疗前18F-FDG PET-CT检查结果.结果130例DLBCL患者18F-FDG PET-CT检查的最大标准摄取值(SUVmax)、病灶代谢体积(MTV)及病灶糖酵解总量(TLG)的中位数分别为19.93、34.45cm3、459.92.单因素分析结果显示:美国东部肿瘤协作组(ECOG)评分、AnnArbor分期、β2微球蛋白水平、乳酸脱氢酶水平、肿瘤直径、骨髓侵犯、改良国际预后指数(NCCN-IPI)评分、MTV、TLG均是患者无进展生存(PFS)率及总生存(OS)率的影响因素(均P<0.05);年龄是患者PFS率的影响因素(P<0.05).由于MTV与TLG高度相关,多因素分析时,二者中仅纳入TLG,结果显示:ECOG评分、Ann Arbor分期、NCCN-IPI评分及TLG是影响患者PFS率的独立因素(均P<0.05);NCCN-IPI评分及TLG是影响患者OS率的独立因素(均P<0.05).根据NCCN-IPI评分和TLG将患者分为低危组、中危组和高危组.低、中、高危组患者3年PFS率分别为66.0%、36.8%、26.1%,3年OS率分别为70.0%、49.1%、39.1%,差异均有统计学意义(均P<0.05).结论18F-FDG PET-CT所测得的TLG是影响DLBCL患者PFS及OS的独立预后因素,对DLBCL患者预后判断具有一定的参考价值.

Prognostic value of 18F-FDG PET-CT in patients with diffuse large B-cell lymphoma

Objective To investigate the prognostic value of 18F-FDG PET-CT in patients with diffuse large B-cell lymphoma(DLBCL).Methods The clinical data of 130 DLBCL patients from June 2009 to May 2015 and pretreatment 18F-FDG PET-CT were retrospectively analyzed.Results The 130 DLBCL patients' median of maximal standard uptake value(SUVmax),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)was 19.93,34.45 cm3,459.92 respectively.Univariate analysis showed that the affecting factors of progression-free survival(PFS)and overall survival(OS)rate included Eastern Cooperative Oncology Group(ECOG)grade,Ann Arbor stage,β2-MG,lactate dehydrogenase level,tumor diameter,bone marrow involvement,National Comprehensive Cancer Network International Prognostic Index(NCCN-IPI),MTV and TLG(all P <0.05),while age was related with PFS rate(P<0.05).As MTV and TLG were strongly correlated,only TLG measure was used for multivariate analysis.The result showed that ECOG grade,Ann Arbor stage,NCCN-IPI and TLG were statistically significant predictors of PFS rate,and NCCN-IPI and TLG were independent factors of OS rate(all P<0.05).According to TLG and NCCN-IPI,the patients were divided into three groups: low risk group,mediate risk group and high risk group.The 3-year PFS rates of these groups were 66.0%,36.8% and 26.1% respectively(P< 0.05),and the 3-year OS rates of these groups were 70.0%,49.1% and 39.1% respectively(P < 0.05).Conclusion TLG in 18F-FDG PET-CT is an independent prognostic factor for PFS and OS in patients with DLBCL,which has a reference value for prognosis of DLBCL.