18^F-FDGPET—CT在评价弥漫大B细胞淋巴瘤早期化疗反应中的应用价值

Significance of 18^F-FDG PET-CT in monitoring early chemotherapy response in patients with diffuse large B-cell lymphoma

目的 探讨18^F-FDG PET-CT在评价弥漫大B细胞淋巴瘤（DLBCL）早期化疗反应中的应用价值.方法 56例DLBCL初诊患者,采用CHOP或R-CHOP方案化疗,分别于化疗前和化疗2个周期后进行18^F-FDG PET-CT检查.比较完全反应组（30例）、部分反应组（18例）和无反应组（8例）间的完全缓解率及每组化疗前后最大标准摄取值（SUVmax）.结果 完全反应组、部分反应组和无反应组的完全缓解率分别为93.33％（28/30）、66.67％（12/18）和12.50％（1/8）,三组间差异有统计学意义（x2=21.62,P＜0.005）.完全反应组的完全缓解率高于部分反应组（x^2=4.00,P＜ 0.05）;完全反应组、部分反应组的完全缓解率高于无反应组（x^2=18.58,P＜0.005;x^2=4.51,P＜0.05）.完全反应组化疗前SUVmax为19.00±5.03,化疗后PET-CT示所有病灶均消失;部分反应组化疗前SUVmax为17.18±4.68,明显高于化疗后的5.20±3.35,差异有统计学意义（t=14.32,P＜0.001）;无反应组化疗前SUVmax为16.63±6.49,与化疗后的13.81±5.95相比,差异无统计学意义（t=2.073 2,P＞0.05）.结论 18FFDGPET-CT在DLBCL化疗早期有助于预测化疗疗效.

Objective To assess the value of 18^F-FDG PET-CT in monitoring early chemotherapy response in patients with diffuse large B-cell lymphoma （DLBCL）.Methods 56 patients with DLBCL received 18^F-FDG PET-CT before and after 2 cycles of chemotherapy （CHOP or R-CHOP protocol）.The patients were divided into 3 groups,including complete response group （30 cases）,partial response group （18 cases） and no response group （8 cases）.The x^2 test was performed on comparison of complete remission rate and the t test on SUVmax.Results Complete remission rate of complete response group,partial response group and no response group were 93.33 % （28/30）,66.67 % （12/18）,and 12.50 % （1/8）,respectively （x^2 =21.62,P 〈 0.005）.Complete remission rate of complete response group was higher than that of partial response group （x 2 =4.00,P 〈 0.05）.Complete remission rates of complete response group and partial response group were higher than that of no response group （x2 =18.58,P 〈 0.005; x^2 =4.51,P 〈 0.05）.A significant difference was observed in SUVmax of partial response group before and after chemotherapy （17.18±4.68 vs 5.20±3.35,t =14.32,P 〈 0.001） and no obvious difference was showed in SUVmax of no response group between before and after chemotherapy （16.63±6.49 vs 13.81±5.95,t =2.073 2,P 〉 0.05）.Conclusion 18F-FDG PET-CT is very useful and helpful for predicting early chemotherapy response in DLBCL.