^(18)F-FDG符合线路SPECT显像在非霍奇金淋巴瘤预后评估中的作用

The role of ^(18)F-FDG dual-headed SPECT coincidence imaging on prognosis in non-Hodgkin lymphoma

目的:探讨18F-脱氧葡萄糖(18F-FDG)符合线路单光子发射计算机断层显像(SPECT)在淋巴瘤预后评估中的应用价值。方法:回顾分析52例非霍奇金淋巴瘤(NHL)患者治疗前和4程化疗后18F-FDG符合线路SPECT显像结果,治疗后18F-FDG符合线路SPECT显像反应按照完全缓解(CR)、部分缓解(PR)或无反应(NR)评分。联合使用国际预后指数(IPI)和治疗后18F-FDG符合线路显像SPECT反应评估患者的无失败生存率(FFS)。结果:4程化疗后,18F-FDG符合线路显像反应CR的患者34例,2年FFS是75%;PR患者12例,2年FFS是41%,未缓解6例,2年FFS是0,23例患者疾病进展或复发。18F-FDG符合线路显像反应CR、PR和NR的患者之间的FFS明显不同(P<0.01)。将18F-FDG符合线路SPECT显像反应与IPI相联合,至少分为明显不同的4组,联合危险度评分(CRS)0～1(14例患者)2年FFS77%,CRS2～3(26例患者)2年FFS64%,CRS4(8例患者)2年FFS25%和CRS5～6(5例患者)2年FFS为0,4组患者的2年FFS明显不同(P<0.01)。结论:18F-FDG符合线路显像反应为初发的NHL患者提供了较为准确的预后指标。

Objective：To assess is ^18F-FDG dual-headed SPECT coincidence imaging in prognosis of non-Hodgkin lymphoma. Method：Fifty two patients with lymphoma before treatment and after 4 chemotherapy courses were analyzed retrospectively. FDQ SPECT response after 4 courses were scored as complete remission （CR）, partial remission （PR）, no remission （PR）, and no response （NR）. Fifty two patients were assessed for FFS by International Prognostic Index （IPI） together with FDG SPECT response. Result： After 4 courses, 34 patients were CR, 12 patients were PR and 6 patients were NR. The 2-year FFS for CR, PR and NR was 75%, 41% and 0 respectively. Based on survival analysis, the FFS was significantly different for each risk group （P〈0. 01）. The combined use of the IPI and FDG SPECT scans after 4 chemotherapy courses were identified at least 4 categories： CRS （Combined Risk Score） 0-1 （n=14）, CRS 2-3 （n=26）, CRS 4 （n=8） and CRS 5-6 （n=5）. The 2-year FFS was 77%, 64%, 25% and 0, respectively. The FFS was significantly different for each risk group （P〈0. 01）. Conclusion：^18F-FDG SPECT scans provides a more accurate prognostic instrument for patients with NHL.