PET/CT对RCHOP初治的弥漫大B细胞淋巴瘤患者预后分析

The Prognostic Value of Baseline PET/CT in Diffuse Large B-Cell Lymphoma Patients Treated with RCHOP

目的评估基线^(18)F-FDG PET/CT参数:SUV_(max)、MTV、TLG对RCHOP初治的DLBCL患者的疗效及生存预后价值。方法回顾性分析我科初治的、接受RCHOP方案治疗的DLBCL患者20例,分析基线SUV_(max)、MTV、TLG与各临床病理因素、实验室化验指标之间的相关性,用ROC曲线分析法确定基线SUV_(max)、MTV、TLG最佳临界点,分析其对疗效及生存预后的预测价值。结果(1)Ⅰ/Ⅱ期患者基线SUVmax均值远低于Ⅲ/Ⅳ期患者,有无B症状、IPI危险分层等不同因素的MTV均值差别较大,Ann Arbor分期、ECOG评分、LDH水平、结外受侵个数、IPI危险分层等不同因素的TLG均值差别较大,差异均具有统计学意义;(2)MTV<365.5组患者中位PFS优于MTV≥365.5组患者,TLG<2464.02组患者中位PFS优于TLG≥2464.02组患者,差异有统计学意义;(3)年龄≤60岁、无B症状、Ⅰ/Ⅱ期患者、血红蛋白≥120g/L中位PFS相对较高,差异具有统计学意义。结论DLBCL患者的基线MTV、TLG与疗效及生存预后有密切关系,值得进一步研究和临床探索。

Objective To evaluate the prognostic value of ^(18)F-FDG PET/CT parameters: SUVmax, MTV and TLG in DLBCL patients.Methods A total of 20 patients with DLBCL who were treated with RCHOP were retrospectively analyzed. The correlations of SUVmax, MTV and TLG with clinicopathological factors and laboratory indexes were analyzed. The optimal critical value of SUVmax, MTV and TLG were determined by ROC analysis, and their prognosis values were analyzed.Results(1)The mean SUVmax of stage Ⅰ/Ⅱ patients was much lower than that of stage Ⅲ/Ⅳ patients;There were significant differences in mean MTV among different factors, such as B symptoms, IPI risk stratification, and there were significant differences in mean TLG among different factors, such as Ann Arbor stage, ECOG score, LDH level, the number of extranodal invasion and IPI risk stratification;(2)The median PFS of patients with MTV<365.5 were significantly higher than those with MTV≥365.5, while the median PFS of patients with TLG<2 464.02 were significantly higher than those with TLG≥2 464.02, and the difference was statistically significant;(3)The median PFS of patients with age≤60 years, no B symptoms, stage Ⅰ or Ⅱ, or hemoglobin≥120 g/L was relatively higher, and the difference was statistically significant.Conclusion Baseline MTV and TLG of DLBCL patients are closely related to the curative effect and survival prognosis, which has a great clinical value.