18F-FDG PET/CT在T细胞淋巴瘤疗效评价中的临床价值

Clinical significance of 18F-FDG PET/CT evaluation of response to treatment in T-cell lymophoma

目的 探讨18 F-FDG PET/CT在T细胞淋巴瘤临床再分期、评价疗效、监测复发及提示预后方面的临床价值.方法 回顾性分析34例T细胞淋巴瘤患者的PET/CT显像结果,评价其在临床再分期、评价疗效、监测复发及提示预后方面的价值.结果 34例患者中20例分期Ⅰ～Ⅱ期者治疗后6例分期上调,9例分期下调,5例分期未改变；14例分期Ⅲ～Ⅳ期者治疗后3例分期上调,4例分期下调,7例分期未改变.34例T细胞淋巴瘤患者中12例达完全缓解（CR）,11例达部分缓解（PR）,2例处于稳定（SD）状态,9例进展（PD）.34例患者中有25例至少经6个疗程化疗后行PET/CT检查,疗效较佳组的标准化摄取（SUV）值比疗效不佳组的SUV值小（分别为4.3±3.1和11.2＋6.1）,差异有统计学意义（P =0.009）.8例患者于治疗前后均行PET/CT检查,治疗前后SUV值差异有统计学意义（P=0.000）.25例外周T细胞淋巴瘤至少经6个疗程化疗后PET/CT评价疗效较佳组与疗效不佳组的平均生存时间（分别为82.7和39.5个月）差异有统计学意义（P=0.015）.结论 T细胞淋巴瘤治疗后行PET/CT检查对于指导临床再分期、评价疗效、监测复发及提示预后有一定意义。

Objective To investigate the usefulness of 18F-FDG PET/CT imaging in restaging, evalu-ating the treatment outcome, monitoring relapse and predicting prognosis of T-cell lymphoma. Methods Retrospective analysis of PET/CT image results of thirty-four patients with T-cell lymphoma, and to evaluate its clinical significance in restaging, treatment efficiency, relapse monitor and progrosis prediction. Results Clinical restaging among the 20 stage I and Ⅱ patients, 6 were ascended, 9 descended and 5 unchanged. Restaging among the other 14 stage Ⅲ and IV patients, 3 were ascended, 4 descended and 7 unchanged. There were 12 patients in complete remission（CR）, 11 in partial remission（PR）, 2 in stable disease （SD） and 9 in progressive disease （PD） among all the 34 patients. There is obvious statistical difference of the standardized uptake value （SUV） between the efficacy group and the inefficacy group after treatment of 6 courses at least in 25 patients among all the 34 patients（ P = 0. 009 ）. There is obvious statistical difference of the SUV value before and after treatment in 8 patients among all the 34 patients （ P = 0. 000 ）. There is obvious statistical difference in the survival time between the efficacy group and the inefficacy group after treatment of 6 courses at least in 25 patients among all the 34 patients（P = 0. 015 ）. Conclusions 18F-FDG PET/CT imaging plays an very important role in guiding clinical restaging, evaluating the treatment outcome, monitoring relapse and predicting prognosis of T-cell lymphoma. It is helpful to establish personalized treatmentplanning.