自体造血干细胞移植前或后18F-FDGPET／CT显像对非霍奇金淋巴瘤的预后评估

Predictive value of 18F-FDG PET/CT before or after autologous hematopoietic stem cell transplanta- tion for the clinical outcome of patients with non-Hodgkin＇s lymphoma

目的探讨自体造血干细胞移植（Auto-HSCT）前或后18F-脱氧葡萄糖（FDG）PET／CT显像对非霍奇金淋巴瘤（NHL）患者的预后评估价值。方法回顾眭分析2007年6月至2016年5月间行18F-FDGPET／CT显像的NHL患者58例，其中Auto-HSCT前显像的患者为40例（男32例，女8例：中位年龄39岁）；Auto-HSCT后显像的患者为34例（男23例，女11例；中位年龄34岁）；有16例在移植前后皆行PET／CT显像。根据18FFDGPET／CT结果将患者分为PET／CT阳性组和阴性组，利用Kaplan-Meier法绘制生存曲线分析各组的无进展生存（PFS）和总生存（OS），并通过log-rank检验比较组间差异。计算各组3年的PFS率和0s率，通过Fisher确切概率法比较组间差异。结果（1）Auto-HSCT前显像患者：PET／CT阴性组（27例）和阳性组（13例）的PFS生存曲线不同（X^2=4．187，P〈0．05），2组3年PFS率分别为63．6％（14／22）与1／7（P=0．031）；2组OS生存曲线差异无统计学意义（疋。=1．777，P〉0．05）。（2）Auto-HSCT后显像患者：PET／CT阴性组（18例）和阳性组（16例）的PFS生存曲线不同（爿。15．430，P〈0．01），2组Os生存曲线亦不同（X^2=7．726，P〈0．01）；2组3年PFS率分别为8／10和2／12（P=0．005），3年OS率分别为8／10与4／12（P=0．038）。结论Auto-HSCT前或后行18F-FDGPET／CT显像具有提示NHL患者预后的价值。

Objective To evaluate the predictive value of lSF-fluorodeoxyglucose （FDG） PET/CT before or after autologous hematopoietic stem cell transplantation （Auto-HSCT） in patients with non- Hodgkin＇s lymphoma （NHL）. Methods Fifty-eight NHL patients who underwent PET/CT scan before or after Auto-HSCT were retrospectively analyzed. Between June 2007 and May 2016, 40 patients （32 males, 8 females; median age 39 years） underwent lSF-FDG PET/CT pre-transplantation, and 34 patients （23 males, 11 females; median age 34 years） underwent lSF-FDG PET/CT post-transplantation. There were 16 patients underwent both pre- and post-transplantation imaging. PET/CT results were categorized as positive or negative according to the standard response criteria. The predictive value of PET/CT was evaluated with progression-free survival （PFS） and overall survival （OS） using Kaplan-Meier survival analysis and log- rank test. Three-year PFS and OS of different groups were compared with Fisher exact test. Results （ 1 ） 18F_ FDG PET/CT before Auto-HSCT ： PFS of patients in PET/CT negative group （ n = 27 ） and positive group （ n = 13 ） were significantly different （X^2 = 4.187, P〈 0.05 ）, 3-year PFS was 63.6% （14/22） vs 1/7 （ P = 0. 031）. However, OS of the 2 groups were not significantly different （X^2= 1.777, P〉0.05）. （2）lSF-FDG PET/CT after Anto-HSCT： PFS and OS of patients in PET/CT negative group （n= 18） and positive group （n= 16） were significantly different （X^2 values： 15.430, 7.726, both P〈0.01）. The 3-year PFS and OS of the 2 groups were 8/10 vs 2/12（P=0.005） and 8/10 vs 4/12 （P=0.038）, respectively. Conclusion 18F- FDG PET/CT before or after Auto-HSCT could provide prognostic information for NHL patients.