| 翁翔,姜婷,赵明哲.弥漫大B细胞淋巴瘤化疗前后18F-FDG PET/CT参数肿瘤与非肿瘤摄取比的变化程度与预后的相关研究[J].浙江中西医结合杂志,2024,34(8): |
| 弥漫大B细胞淋巴瘤化疗前后18F-FDG PET/CT参数肿瘤与非肿瘤摄取比的变化程度与预后的相关研究 |
| The correlation between the changes of tumor to background ratio before and after chemotherapy by 18F-FDG PET/CT and the prognosis of diffuse large B-cell lymphoma |
| 投稿时间：2024-03-08 修订日期：2024-04-10 |
| DOI： |
| 中文关键词: 弥漫大B细胞淋巴瘤 正电子发射断层显像 肿瘤与非肿瘤摄取比 标准摄取值 肿瘤代谢体积 糖酵解总量 改良国际预后指数 |
| 英文关键词:Diffuse large B-cell lymphoma Positron emission tomograph Tumor to background ratio Standard uptake value Metabolic tumor volume Total glycolysis National Comprehensive Cancer Network International Prognostic Index |
| 基金项目:金华市科技计划项目(2023-4-079) |
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| 中文摘要: |
| 目的 应用氟代脱氧葡萄糖（18F-FDG）正电子发射断层显像（PET）/CT的代谢参数肿瘤与非肿瘤摄取比（TBR）化疗前后的变化程度来评估弥漫大 B 细胞淋巴瘤（DLBCL）患者临床预后的应用价值。方法 回顾性总结2020年3月至2023年10月于我院病理确诊DLBCL接受R-CHOP化疗方案（利妥昔单抗+环磷酰胺+表柔比星+长春地辛+地塞米松）至少4个疗程的患者103例为研究对象，随访时间6~40个月，中位时间27.5个月。根据预后分为良好组66例和不良组37例（包括疾病稳定和进展、严重化疗并发症以及死亡）。化疗前和化疗4个疗程后采用18F-FDG PET/CT测量代谢参数包括标准摄取值的最大值（SUVmax）、肿瘤代谢体积（MTV）、糖酵解总量（TLG）和TBR，并计算差值。结果 与预后不良组相比，良好组肿瘤最大直径明显缩小，III~IV期和骨髓侵犯减少，改良国际预后指数（NCCN?IPI）降低，化疗后TBR值显著降低，而差值显著增加（P＜0.05），两组化疗前后SUVmax、MTV和TLG值以及差值比较，差异均无统计学意义（P＞0.05）。受试者工作特征曲线（ROC）显示，TBR差值预测化疗后预后不良的曲线下面积（AUC）为0.870（95%CI=0.783~0.957，P＜0.001），显著高于NCCN?IPI的AUC值0.803（Z=2.032，P=0.003）。结论 18F-FDG PET/CT代谢参数TBR化疗前后的差值可作为DLBCL患者临床预后的重要预测指标。 |
| 英文摘要: |
| Objective To evaluate the clinical prognosis of diffuse large B-cell lymphoma (DLBCL) patients using fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT metabolic parameter-the changes of tumor to background ratio (TBR) before and after chemotherapy. Methods A retrospective review was conducted on 103 patients with pathologically confirmed DLBCL who received R-CHOP chemotherapy regimen (rituximab+cyclophosphamide+epirubicin+vindesin+dexamethasone) for at least 4 courses from March 2020 to October 2023 in our hospital. The follow-up period was 6~40 months, with median time of 27.5 months. According to prognosis, they were divided into good group(n=66) and poor group (n=37,including disease stability and progression, severe chemotherapy complications, and death). Before and after 4 courses of chemotherapy, 18F-FDG PET/CT was used to measure metabolic parameters including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), total glycolysis (TLG), and TBR, then the differences were calculated. Results Compared with the poor prognosis group, the maximum diameter of tumor in the good group was signigicantly smaller,stage III~IV and bone marrow invasion were less,National Comprehensive Cancer Network International Prognostic Index (NCCN -IPI) was lower, TBR value after chemotherapy was less,while the difference was higher,too(P<0.05). There were no differences of SUVmax, MTV, and TLG values and the differences between the two groups (P>0.05). The receiver operating characteristic curve (ROC) showed that area under curve (AUC) of TBR difference for predicting poor prognosis after chemotherapy was 0.870 (95% CI=0.783~0.957, P<0.001), which was significantly higher than the AUC of NCCN ? IPI 0.803 (Z=2.032, P=0.003). Conclusion The metabolic parameter TBR difference before and after chemotherapy of 18F-FDG PET/CT could serve as an important predictive indicator of clinical prognosis in DLBCL patients. |
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