中期氟18-脱氧葡萄糖正电子发射计算机断层显像-计算机断层扫描显像3种评价方法在结外NK/T细胞淋巴瘤中的预后价值探讨

Prognostic value of fluorine 18 fluorodeoxyglucose positron emission tomography-computed tomography three methods in the mid-stage therapy of extranodal natural killer/T-cell lymphoma patients

目的探讨基于氟18-脱氧葡萄糖(^(18)F-FDG)正电子发射计算机断层显像-计算机断层扫描(PET-CT)的国际一致化项目(IHP)法、Deauville 5分法和最大标准摄取值下降率(△SUVmax)法3种方法在结外自然杀伤/T细胞淋巴瘤(ENKL)治疗中期的疗效评估价值,以期寻找最佳评价方法。方法回顾性分析经病理学确诊的69例ENKL患者的特征,并且在治疗前及中期都进行了18 F-FDG PET-CT检查,分别利用IHP法、Deauville 5分法和△SUVmax法对患者的PET-CT进行评价,并进行敏感性、特异性分析。利用ROC曲线得出最佳临界值,并以相应的临界值分组,对病例进行预后分析。结果△SUVmax和△SUVmax%的临界值分别为5.75和52.8%。IHP阴性组、Deauville阴性组、△SUVmax≥5.75组和△SUVmax%≥52.8%组的5 a疾病无进展生存率(67.3%、78.5%、72.5%、82.5%)均优于对应的IHP阳性组、Deauville阳性组、△SUVmax<5.75组和△SUVmax%<52.8%组(55.1%、42.0%、17.0%、20.0%;χ^(2)=5.660,P=0.017;χ^(2)=16.295,P<0.001;χ^(2)=14.795,P<0.001;χ^(2)=34.824,P<0.001)。Deauville 5分法、△SUVmax法和△SUVmax%法对疗效的预测优于IHP法。结论中期18 F-FDG PET-CT的Deauville 5分法、△SUVmax和△SUVmax%法在预测ENKL疗效和患者预后方面具有优势。

Objective To investigate prognostic value of fluorine 18 fluorodeoxyglucose(^(18)F-FDG)positron emission tomography-computed tomography(PET-CT)three methods[international harmonization project(IHP),Deauville 5-point scale and maximum standard uptake value rate(△SUVmax)]in the mid-stage therapy of extranodal natural killer/T-cell lymphoma(ENKL)patients,and in order to find the best evaluation method.Methods Sixty-nine ENKL patients confirmed by pathological examination were analyzed retrospectively,and all the patients had performed 18 F-FDG PET-CT examinations before and during treatment.The PET-CT results were evaluated by IHP,Deauville 5-point scale and△SUVmax criteria,the sensitivity and specificity were analyzed.ROC curves were drawn to get the optimal critical values,the patients were divided into the two groups according to the corresponding critical values,and the prognosis was analyzed.Results The cutoff values of△SUVmax and△SUVmax%were relatively 5.75 and 52.8%.The IHP negative group,the Deauville negative group,the△SUVmax≥5.75 group and the△SUVmax%≥52.8%group(67.3%,78.5%,72.5%and 82.5%)showed the improved survival rates than the IHP positive group,the Deauville positive group,the△SUVmax<5.75 group and the△SUVmax%<52.8%group(55.1%,42.0%,17.0%and 20.0%;χ^(2)=5.660,P=0.017;χ^(2)=16.295,P<0.001;χ^(2)=14.795,P<0.001;χ^(2)=34.824,P<0.001).Deauville 5-point scale,△SUVmax criteria and△SUVmax%criteria were better than IHP method in predicting curative effect.Conclusion In the mid-stage therapy,Deauville 5-point scale,△SUVmax and△SUVmax%criteria were better in predicting effect and prognosis of ENKL patients.