18F—FDGPET／CT可用于多发性骨髓瘤临床分期及病灶代谢活性评价

18F-FDG PET/CT in staging and metabolic activity assessment of multiple myeloma

目的探讨18F－FDG PET/CT在多发性骨髓瘤（MM）临床分期及评价病灶葡萄糖代谢活性中的应用价值。 方法回顾性分析2010年5月至2015年4月在北京大学第一医院行18F－FDG检查的25例MM初诊患者（男13例，女12例；年龄39～67岁）资料。依据18F－FDG PET/CT结果进行D－S plus分期，比较该分期与D－S分期结果的差异。比较D－S plusⅢ期和非Ⅲ期患者的病灶葡萄糖代谢活性及骨髓浆细胞比例。采用两样本t检验和Wilcoxon秩和检验分析数据。 结果25例MM患者病灶的SUVmax范围为1.8～12.0，均值为5.15±2.74。25例MM患者按D－S分期，Ⅰ、Ⅱ、Ⅲ期患者分别为7、4、14例；而根据D－S plus分期，Ⅰ、Ⅱ、Ⅲ期患者分别为3、1、21例，改变了D－S分期中7例患者（28%，7/25）的临床分期。D－S plus分期Ⅲ期和非Ⅲ期患者的SUVmax差异有统计学意义（5.75±2.54和3.00±0.70；t＝2.12，P〈0.05），而骨髓浆细胞比例差异无统计学意义[17.50%（4.25%～41.75%）和11.15%（10.25%～36.57%）；z＝0.05，P〉0.05]。 结论18F－FDG PET/CT可用于MM的临床分期和评价病灶的葡萄糖代谢活性。

Objective To investigate the clinical value of 18F-FDG PET/CT in staging multiple myeloma （MM） and evaluating the glucose metabolic activity of MM. Methods A total of 25 MM patients （ 13 males, 12 females, age： 39-67 years） from May 2010 to April 2015 were enrolled in this retrospective study. The SUVm= of each patient was recorded. D-S plus staging according to 1SF-FDG PET/CT was compared with the traditional D-S staging. The SUVm and the percentage of plasmacytes of bone marrow of phase Ⅲ and non-phase Ⅲ （phase Ⅰ and Ⅱ ） according to D-S plus staging were compared. Two-sample t test and Wilcoxon rank sum test were used to analyze the data. Results In 25 MM patients, the range of SUVmax of lesions was 1.8-12. 0 and the mean value was 5.15±2.74. According to D-S staging, the numbers of patients with phase Ⅰ , Ⅱ and Ⅲ were 7, 4 and 14, respectively. While the numbers were 3, 1 and 21 by D-S plus staging. Based on the D-S plus staging system, stages of 7 patients （28%, 7/25 ） were changed. According to the D-S plus staging system, the SUVmax between phase In and non-phase m patients was significantly different （5.75±2.54 vs 3.000. 70; t = 2.12, P〈0.05 ）, while the percentage of plasma- cytes of bone marrow between the 2 groups had no significant difference （17.50% （4.25%-41.75%） vs 11.15%（10.25%-36.57%） ; z=0.05, P〉0.05）. Conclusion 1SF-FDG PET/CT is of clinical importance for MM staging and metabolic activity assessment of MM.