弥漫大B细胞淋巴瘤在化疗中期行^(18)F-FDG PET/CT的临床应用价值

The clinical value of ^(18)F-FDG PET/CT in patients with diffuse large B cell lymphoma in chemotherapy interim

目的探讨18氟标记的脱氧葡萄糖正电子发射计算机断层显像(fluorie-18 fluorodeoxyglucose positron emission tomography,18F-FDG PEC/CT)在弥漫大B细胞淋巴瘤化疗中期疗效中的临床应用价值。方法分析经病理确诊的42例弥漫大B细胞淋巴瘤化疗中期18F-FDG PET/CT显像结果;42例患者均在治疗前和化疗2~4个周期后行18F-FDG PET/CT显像,图像分析采用视图分析及测量病灶最大摄取值方法相结合。42例患者在化疗6个周期后根据影像学诊断结果和临床医师综合判断分为有效组和无效组,有效组31例,无效组11例。本研究所有数据采用SPSS17.0统计软件进行统计学分析并评价qSUVmax(化疗前SUVmax)、zSUVmax(化疗中期即2~4个疗程后)以及△SUVmax(化疗前与化疗中期的SUVmax差值)。结果 (1)两组患者年龄、性别、临床分期与化疗前SUVmax值差异均无统计学意义。(2)两组间的zSUVmax、△SUVmax化疗中SUVmax值、△SUVmax差异均有统计学意义;相比治疗前,有效组的zSUVmax水平低,呈下降趋势;无效组的zSUVmax水平高,呈上升趋势。△SUVmax有效组呈下降趋势,无效组呈上升趋势。(3)△SUVmaxROC曲线显示曲线下面积0.918(P<0.01),差异均有统计学意义。结论在化疗中期对弥漫大B细胞淋巴瘤的患者行18F-FDG PET/CT显像对临床疗效的评价有较大的临床应用价值。

Objectives To explore the clinical value of 18 F-FDG PET/CT in patients with diffuse large B cell lymphoma in their chemotherapy interim.Methods The clinical PET/CT scan data of 42 patients patho-logically proven with DLBCL were analyzed by view analysis,combined with lesions maximum value measuring.42 patients were given the 18 F-FDG PET/CT imaging before the treatment and after 2-4 chemotherapy cycles and they were divided into valid group （31 patients）and invalid group（11 patients） according to the imaging diagnosis and clinical physicians′comprehensive j udgment after 6 cycles of chemo-therapy.SPSS17.0 statistical processing software was adopted to evaluate qSUVmax （SUVmax before chemotherapy）,zSUVmax（mid chemotherapy,after 2-4 chemotherapy cycles）and △SUVmax（the difference between qSUVmax and zSUVmax）.Results The SUVmax values before the chemotherapy in two groups had no statistically significant difference in terms of age,sex,clinical stage;zSUVmax value,delta SUVmax,and SUVmax in two groups had statistical significance in chemotherapy;Compared with the pretreatment,the SUVmax level in the valid group was low and on the decline,the SUVmax level in invalid group was high and on the rise.Delta SUVmax also showed that valid group was on the decline,in-valid group was on the rise;The SUVmax ROC curve displayed the area of 0.918 under the curve （P 〈0.01）,which were statistically significant.Conclusion In the middle of chemotherapy for DLBCL patients,18 F-FDG PET/CT imaging had a great clinical applied value in the evaluation of clinical curative effect.