18F-FDG PET-CT显像在外周T细胞淋巴瘤预后评估中的应用

Prognostic value of 18F-FDG PET-CT in patients with peripheral T-cell lymphoma

目的 探讨化疗中期及治疗后18F-FDG PET-CT显像对外周T细胞淋巴瘤（PTCL）患者预后评估的应用价值.方法 回顾性分析经病理活组织检查和免疫组织化学确诊的44例PTCL患者的18F-FDG PET-CT显像资料.27例患者在化疗中期（3个周期化疗）、35例患者在全部治疗结束后行PET-CT检查,应用无进展生存（PFS）期及总体生存（OS）期作为评价指标,进行预后评估.结果 化疗中期18F-FDG PET-CT显像结果阳性者16例,阴性者1 1例,阳性者和阴性者中位PFS期分别为8个月和30个月,2年PFS率分别为18.8％（3/16）和90.9％（10/11）,差异有统计学意义（x2=13.092,P=0.000）;中位OS期分别为14个月和39个月,3年OS率分别为12.5％（2/16）和63.6％（7/11）,差异有统计学意义（x 2=7.386,P=0.007）.治疗后18F-FDG PET-CT显像结果阳性患者14例,阴性患者21例,阳性者和阴性者中位PFS期分别为10个月和26个月,2年PFS率分别为7.1％（1/14）和76.2％（16/21）,差异有统计学意义（x 2=15.574,P=0.000）;中位OS期分别为22个月和38个月,3年OS率分别为14.3％（2/14）和57.1％（12/21）,差异有统计学意义（x2=6.245,P=0.012）.结论 化疗中期及治疗后PET-CT检查结果对PTCL患者疗效监测及预后判断具有重要意义.

Objective To investigate the prognostic value of interim and post-therapy 18F-FDG PET-CT in patients with peripheral T-cell lymphoma.Methods A retrospective analysis was conducted on data from 44 patients with newly diagnosed peripheral T-cell lymphoma who underwent interim （after 3 cycles of chemotherapy,27 cases） or posttherapy PET-CT （after the completion of first-line therapy,35 cases）.Interim and posttherapy PET-CT status （positive vs negative） was visually interpreted according to criteria of the International Harmonization Project,and PET-CT status was assessed for its ability to predict progression-free survival （PFS） and overall survival （OS）.Results Interim 18F-FDG PET-CT results were positive in 16 cases and negative in 11 cases.The median PFS and OS in the patients with positive results were 8 months and 14 months,respectively,while those in patients with negative results were 30 months and 39 months,respectively.The 2-year PFS and 3-year OS rates in patients with positive results at interim PET-CT were 18.8 % （3/16） and 12.5 % （2/16）,respectively,while those in patients with negative results were 90.0 % （10/11） and 63.6 % （7/11）,respectively （x2 =13.092,P =0.000; x2 =7.386,P =0.007,respectively）.Posttherapy 18F-FDG PET-CT results were positive in 14 cases and negative in 21 cases.The median PFS and OS in patients with positive results were 10 months and 22 months,respectively,while those in patients with negative results were 26 months and 38 months,respectively.The 2-year PFS and 3-year OS rates in patients with positive results at posttherapy PET-CT were 7.1% （1/14） and 14.3 % （2/14）,respectively,while those in patients with negative results were 76.2 % （16/21） and 57.1% （12/21）,respectively （x2 =15.574,P =0.000;x2 =6.245,P =0.012,respectively）.Conclusion Both interim PET-CT status and posttherapy PET-CT status have significant value in monitoring response to therapy and predicting prognosis for patients with peripheral T-cell lymphoma.