中期^(18)F-FDG PET/CT评估结外鼻型NK/T细胞淋巴瘤的预后价值

Prognostic Value of Interim F-FDG PET/CT in Extranodal NK/T-Cell Lymphoma,Nasal Type

目的:探讨中期^(18)F-FDG PET/CT在结外鼻型NK/T细胞淋巴瘤(ENKTL)患者预后评估中的价值。方法:回顾性收集2015年1月至20^(18)年12月在南京医科大学附属上海一院临床医学院(上海市第一人民医院)病理确诊的ENKTL患者21例,在治疗前和中期(2-4个化疗疗程后第3周或放疗后第6周)行^(18)F-FDG PET/CT显像。随访患者完整临床资料,通过韩国预后指数计算、多维尔评分、最大标准摄取值减少率(ΔSUVmax)半定量分析评估患者的无进展生存率及总生存率,并通过COX回归分析影响生存的独立危险因素。结果:21例患者治疗结束后完全缓解11例,部分缓解3例,疾病稳定1例,疾病进展6例。完全缓解患者△SUVmax明显高于非完全缓解患者[(66.07±22.33)%vs(36.87±23.28)%,t=2.927,P=0.009]。受试者工作曲线计算ΔSUVmax最佳分界点为51.45%。中位随访时间32个月。Kaplan-Meier生存分析显示,韩国预后指数、多维尔评分、ΔSUVmax预测无进展生存率、总生存率具有统计学意义(P <0.05)。COX回归分析显示,多维尔评分是影响无进展生存率的独立危险因素(P <0.05),韩国预后指数、ΔSUVmax是影响总生存率的独立危险因素(P <0.05)。结论:中期^(18)F-FDG PET/CT显像在ENKTL患者预后评估中有一定的价值。

Objective:To explore the value of interim ^(18)F-FDG PET/CT in the prognosis of patients with extranodal NK/T-cell lymphoma,nasal type(ENKTL).Methods:Twenty-one patients with ENKTL who were pathologically diagnosed at Shanghai General Hospital of Nanjing Medical University(Shanghai General Hospital) from January 2015 to December 20^(18) were retrospectively collected,and ^(18)F-FDG PET/CT imaging was performed before and during treatment(3 weeks after 2-4 chemotherapy courses or 6 weeks after radiotherapy).The complete clinical data of the patients were followed up.The progression-free survival(PFS) and overall survival(OS) were analyzed by the Korean prognostic index(KPI),Deauville score(DS) and the maximum standard uptake reduction rate(ΔSUVmax).The independent risk factors affecting survival were evaluated by COX regression.Results:After treatment,11 patients had complete remission(CR),3 had partial remission(PR),1 had stable disease(SD),and 6 had disease progression(PD).The CR patients’ ΔSUVmax was significantly higher than non-CR patients [(66.07±22.33) % vs(36.87±23.28) %,t=2.927,P=0.009].Calculated from the receiver operating curve(ROC),the optimal cut-off point ofΔSUVmax was 51.45%.The median follow-up time was 32 months.Kaplan-Meier survival analysis showed that KPI,DS and ΔSUVmax had significance in predicting PFS and OS(P <0.05).COX regression analysis showed that DS was an independent risk factor affecting PFS(P <0.05),and KPI and ΔSUVmax were independent risk factors affecting OS(P <0.05).Conclusion:Interim ^(18)F-FDG PET/CT imaging has some value in the prognostic evaluation of patients with ENKTL.