18F-FDG PET/CT对弥漫性大B细胞淋巴瘤的预后价值

doi:10.12117/jccmi.2020.05.011

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摘要目的：探讨18F-脱氧葡萄糖（FDG）PET/CT显像中肿瘤总代谢体积（TMTV）对弥漫性大B细胞淋巴瘤（DLBCL）的预后评估价值。方法：回顾性分析2014年4月—2018年8月于我院接受CHOP联合利妥昔单抗化疗方案并经病理证实为DLBCL的65例患者。所有患者临床资料完善，治疗前均行18F-FDG PET/CT显像，获得患者的TMTV。绘制ROC曲线获得TMTV截断值，采用卡方检验或连续性校正的卡方检验、Kaplan-Meier生存曲线、单因素和多因素Cox回归分析确定与预后相关的因素。结果：纳入人群的TMTV平均值为158 cm3，TMTV最佳截断值为146 cm3。低TMTV组2年PFS率、OS率分别为43.1%、45.3%，高TMTV组2年PFS率、OS率分别为5.2%、15.3%（P＜0.001）。多因素回归分析显示MYC与BCL-2是PFS的独立预测指标。MYC是OS的独立预测指标。TMTV是PFS和OS共同的独立预测指标。低TMTV患者较高TMTV患者预后更好。结论：18F-FDG PET/CT显像中的TMTV可作为预测DLBCL预后的重要指标。

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	解婷
	徐凯
	韩翠平
	陈青峰

关键词 ：淋巴瘤, 大细胞, 弥漫型, 正电子发射断层显像术, 体层摄影术, 螺旋计算机, 氟脱氧葡萄糖F18

Abstract：Objective: The prognostic impact of total metabolic tumor volume(TMTV) measured on pretreatment 18F-FDG PET/CT was investigated in patients with diffuse large B-cell lymphoma(DLBCL). Methods: A total of 65 consecutive patients with DLBCL who received Rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone chemotherapy(R-CHOP) as first-line treatment and baseline FDG PET/CT were retrospectively evaluated. Receiver operating characteristic curve analysis was used to determine the optimal cut-off values for the metabolic parameters. The relationships between study variables and patient survival were tested using Cox regression analysis. Patient survival rates were derived from Kaplan-Meier curves and compared by using the log-rank test. Results: In patients with a low TMTV(<146 cm3), the 2-year progression free survival(PFS) rate was 43.1% and the overall survival(OS) rate was 45.3%, in contrast to 5.2% and 15.3%, respectively, in those with a high TMTV(≥146 cm3). Conclusions: TMTV of 18F-FDG PET/CT could be used as an important prognostic indicator for DLBCL.

Key words： Lymphoma, large-cell, diffuse Positron-emission tomography Tomography, spiral computed; Fluorodeoxyglucose F18

收稿日期: 2019-09-23

PACS:	Ｒ733.1
	Ｒ817.4
	Ｒ814.42

通讯作者: 徐凯，徐州医科大学附属医院，221000。E-mail：xukaixz@163.com

作者简介: 解婷（1993-），女，江苏徐州人，在读硕士研究生。E-mail：1115457557@qq.com

引用本文:

解婷，徐凯，韩翠平，陈青峰. 18F-FDG PET/CT对弥漫性大B细胞淋巴瘤的预后价值[J]. 中国临床医学影像杂志, 2020, 31(5): 350-353.
XIE Ting, XU Kai, HAN Cui-ping, CHEN Qing-feng. Prognostic value of metabolic tumor volume on baseline 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(5): 350-353.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.05.011 或 http://www.jccmi.com.cn/CN/Y2020/V31/I5/350

[1]Cottereau AS, Lanic H, Mareschal S, et al. Molecular Profile and FDG-PET/CT Total Metabolic Tumor Volume Improve Risk Classification at Diagnosis for Patients with Diffuse Large B-Cell Lymphoma[J]. Clin Cancer Res, 2016, 22(15): 3801-3809.
[2]Johnson NA, Slack GW, Savage KJ, et al. Concurrent expression of MYC and BCL2 in diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone[J]. J Clin Oncol, 2012, 30(28): 3452-3459.
[3]Zelenetz AD, Gordon LI, Abramson JS, et al. NCCN Guidelines Insights: B-Cell Lymphomas, Version 32019[J]. J Natl Comprehensive Cancer Network, 2019, 17(6): 650-661.
[4]Duehrsen U, Andreas H, Stefan M, et al. Positron Emission Tomography(PET) Guided Therapy of Aggressive Lymphomas—a Randomized Controlled Trial Comparing Different Treatment Approaches Based on Interim PET Results(PETAL Trial)[J]. Blood, 2014, 124(21): 391.
[5]Boellaard R, Delgado-Bolton R, Oyen WJ, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 20[J]. Eur J Nucl Med Mol Imaging, 2015, 42(2): 328-354.
[6]Song MK, Yang DH, Lee GW, et al. High total metabolic tumor volume in PET/CT predicts worse prognosis in diffuse large B cell lymphoma patients with bone marrow involvement in rituximab era[J]. Leukemia Res, 2016, 42(3): 1-6.
[7]Xie M, Wu K, Liu Y, et al. Predictive value of F-18 FDG PET/CT quantization parameters in diffuse large B cell lymphoma: a meta-analysis with 702 participants[J]. Med Oncol(Northwood, London, England), 2015, 32(1): 446.
[8]Meignan M, Sasanelli M, Casasnovas RO, et al. Metabolic tumour volumes measured at staging in lymphoma: methodological evaluation on phantom experiments and patients[J]. Eur J Nucl Med Mol Imaging, 2014, 41(6): 1113-1122.
[9]Zhou Z, Sehn LH, Rademaker AW, et al. An enhanced International Prognostic Index(NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era[J]. Blood, 2014, 123(6): 837-842.
[10]Mikhaeel NG, Smith D, Dumm JT, et al. Combination of baseline metabolic tumour volume and early response on PET/CT improves progression-free survival prediction in DLBCL[J]. Eur J Nucl Med Mol Imaging, 2016, 43(7): 1209-1219.
[11]Sasanelli M, Meignan M, Haioun C, et al. Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma[J]. Eur J Nucl Med Mol Imaging, 2014, 41(11): 2017-2022.
[12]Boellaard R, Delgado-Bolton R, Oyen WJ, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 20[J]. Eur J Nucl Med Mol Imaging, 2015, 42(2): 328-354.
[13]Johnson NA, Slack GW, Savage KJ, et al. Concurrent expression of MYC and BCL2 in diffuse large B-cell lymphoma treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone[J]. J Clin Oncol, 2012, 30(28): 3452-3459.
[14]Horn H, Ziepert M, Becher C, et al. MYC status in concert with BCL2 and BCL6 expression predicts outcome in diffuse large B-cell lymphoma[J]. Blood, 2013, 121(12): 2253-2263.