摘要
目的:探讨弥漫大B细胞淋巴瘤(DLBCL)治疗前^(18)F-脱氧葡萄糖(^(18)F-FDG)PET/CT显像中骨髓摄取模式对预测DLBCL患者预后的价值。方法:回顾性分析156例DLBCL患者的临床资料,所有患者治疗前均行骨髓活检、骨髓涂片、流式细胞分析和^(18)F-FDG PET/CT扫描。以正常肝脏^(18)F-FDG摄取为标准,将患者骨髓摄取模式分为骨髓摄取局灶型增高(f PET+)、骨髓摄取弥漫型增高(d PET+)及骨髓摄取正常型(n PET)。生存分析采用Kaplan-Meier法,组间差异比较采用log-rank检验,采用多因素Cox回归分析确定与预后相关的危险因素。结果:156例患者中,f PET+17例,d PET+28例,n PET 111例。临床诊断骨髓浸润阳性21例,阴性135例。复发进展62例,死亡18例。单因素分析显示,Ann Arbor分期Ⅲ/Ⅳ期、B症状、NCCN-IPI评分、乳酸脱氢酶、骨髓浸润及f PET+与患者无进展生存期(PFS)有关(均P<0.05);Ann Arbor分期Ⅲ/Ⅳ期、NCCN-IPI评分、乳酸脱氢酶、骨髓浸润及f PET+与患者总生存期(OS)有关(均P<0.05);多因素分析显示,Ann Arbor分期III/IV期、乳酸脱氢酶和f PET+(均P<0.05)是PFS独立预测因子。在OS的多变量分析中没有独立预测因子。结论:DLBCL患者治疗前^(18)F-FDG显像中骨髓摄取模式对预后有预测价值,f PET+是患者PFS的独立危险因素。
Objective:To investigate the prognostic value of bone marrow uptake pattern in^(18)F-deoxyglucose(^(18)F-FDG)PET/CT imaging before diffuse large B-cell lymphoma(DLBCL)treatment.Methods:The clinical data of 156 patients with DLBCL were retrospectively analyzed.All patients underwent bone marrow biopsy,bone marrow smear,flow cytometry and^(18)F-FDG PET/CT scan before treatment.Taking normal liver^(18)F-FDG uptake as the standard,the bone marrow uptake patterns of patients were divided into three types:focal increased bone marrow uptake(fPET+),diffusely increased bone marrow uptake(dPET+),and normal bone marrow uptake(nPET).Survival analysis was performed using the Kaplan-Meier method,log-rank test was used for comparison of differences between groups,and multivariate Cox regression analysis was used to identify risk factors associated with prognosis.Results:Among the 156 patients,17 cases were fPET+,28 cases were dPET+,and 111 cases were nPET.Clinical diagnosis of bone marrow infiltration(BMI)was positive in 21 cases and negative in 135 cases.There were 62 cases of recurrence and progression,and 18 cases of death.Univariate analysis showed that Ann Arbor stage III/IV,B symptoms,NCCN-IPI score,lactate dehydrogenase(LDH),BMI+and fPET+were associated with progression-free survival(PFS)(all P<0.05),while Ann Arbor stage III/IV,NCCNIPI score,LDH,BMI+and fPET+were associated with overall survival(OS)(all P<0.05).Multivariate analysis showed that Ann Arbor stage III/IV,LDH and fPET+were independent predictors of PFS(all P<0.05).There were no independent predictors of OS in multivariate analysis.Conclusion:The bone marrow uptake pattern of^(18)F-FDG imaging in DLBCL patients before treatment has a predictive value for DLBCL,while fPET+is an independent risk factor for PFS.
作者
王媛
赵铭
原凌
李娟
WANG Yuan;ZHAO Ming;YUAN Ling;LI Juan(Department of Medical Imaging,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Department of Positron Emission Computed Tomography Center,Shanxi Provincial Cancer Hospital,Taiyuan 030013,Shanxi Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2024年第2期439-444,共6页
Journal of Experimental Hematology
