^(18)F-FDG PET/CT对鼻型结外NK/T细胞淋巴瘤的影像表现及临床价值

^(18)F-FDG PET/CT for extranodular natural killer/T-cell lymphoma nasal type: imaging findings and clinical value

目的探讨^(18)F-FDG PET/CT在鼻型结外NK/T细胞淋巴瘤(ENTCL)初诊及复发者临床诊疗中的应用价值。方法回顾性分析我院近9年来收治的ENTCL患者35例67人次的18F-FDG PET/CT影像表现并对照临床资料,分析上呼吸消化道(UAT)及非上呼吸消化道(NUAT)病灶的影像特点,应用IBM SPSS19.0对初诊、复发者的病灶分布、临床分期及相关SUVmax进行多种比较和生存分析。所有病例均经病理证实。结果所有病灶均为高代谢,UAT病灶主要累及鼻腔、咽部等,NUAT病灶可累及全身各区淋巴结及各个脏器。初诊者以UAT病灶为主,复发者NUAT病灶有增多趋势,初诊及复发病灶SUVmax分别为10.4±4.4、9.6±5.2。不同病灶分布、临床分期及初、复发之间的SUVmax无显著差异(P>0.05)。初诊者治疗后PET/CT评价肿瘤缓解率(89.5%,17/19)高于复发者(33.3%,5/15;P<0.005)。以初复发、临床分期、病灶分布类型、SUVmax水平做cox回归,其总体生存率无显著差异(P>0.05)。结论^(18)F-FDG PET/CT能够敏感检出ENTCL初诊及复发病灶,有助于分期及评价疗效。

Objective To explore the value of ^(18)F-FDG PET/CT in the diagnosis and treatment evaluation in patients with pretreatment or recurrent extranodular natural killer/T-cell lymphoma nasal type(ENTCL). Methods ^(18)F-FDG PET/CT images and clinical records of 35 cases(67 scans) of pathologically confirmed ENTCL treated in our hospital within the last 9 years were analyzed. The imaging characteristics of the upper aerodigestive tract(UAT) and the non-aerodigestive tract(NUAT)lesions were analyzed. Lesion distribution, clinical stages, SUVmax and patient survival data were compared between pretreatment and recurrent cases. Results All the ENTCL lesions were hypermetabolic. The UAT lesions involved mainly the nasal cavity and pharynx, while the NUAT lesions may involve the lymph nodes and all the organs. UAT lesions were more common in pretreatment cases while NUAT lesions tended to increase in recurrent cases. The SUVmax of pretreatment and recurrent lesions were 10.4 ± 4.4 and 9.6 ± 5.2, and showed no significant difference among patients with different lesion distribution patterns, clinical stages, or treatment history. The tumor remission rate evaluated by PET/CT were higher in cases with an initial diagnosis than in those with recurrence[(89.5%(17/19) vs 33.3%(5/15), P<0.005)]. Cox regression analysis revealed no significant differences in the survival rates among patients with different treatment history, clinical stages, lesion distribution patterns, or SUVmax levels(P>0.05). Conclusion ^(18)F-FDG PET/CT can sensitively detect the pretreatment or recurrent lesions in ENTCL patients and helps in accurate tumor staging and curative effect evaluation.