初诊多发性骨髓瘤患者^(18)F-FDG PET-CT代谢参数与临床特征的关系

Relationship between metabolic parameters of ^(18)F-FDG PET-CT and clinical characteristics in newly diagnosed multiple myeloma

目的探讨初诊多发性骨髓瘤(MM)患者^(18)F-FDG PET-CT代谢参数与临床特征之间的关系。方法回顾性分析安徽医科大学第二附属医院2018年6月至2020年12月收治的47例初诊时行^(18)F-FDG PET-CT检查的MM患者临床资料。分析^(18)F-FDG PET-CT代谢参数与患者年龄、性别、疾病分型、DS分期、国际分期系统(ISS)分期、血红蛋白、清蛋白、血清钙、血肌酐、乳酸脱氢酶、β2-微球蛋白、超敏C反应蛋白(hs-CRP)、骨髓浆细胞比例、病灶数、髓外病变之间的关系。结果47例MM患者中,肿瘤代谢体积(MTV)DS分期Ⅲ期患者高于Ⅰ~Ⅱ期患者[172.88(42.69,391.55)比19.63(4.24,42.61),P<0.001]、血清钙≥2.65 mmol/L患者高于血清钙<2.65 mmol/L患者[310.71(99.68,549.62)比58.00(19.63,248.34),P=0.038]、hs-CRP≥3.3 mg/L患者高于hs-CRP<3.3 mg/L患者[211.39(57.79,397.70)比35.34(7.91,153.02),P=0.002]、病灶数>3个患者高于病灶数≤3个患者[211.39(57.79,393.02)比16.43(5.12,38.23),P<0.001]。总病灶葡萄糖酵解(TLG)值DS分期Ⅲ期患者高于Ⅰ~Ⅱ期患者[460.44(92.62,1113.85)比46.68(9.32,89.89),P=0.001]、骨髓浆细胞比例<10%患者高于≥10%患者[1039.36(615.28,1167.80)比150.80(45.36,821.01),P=0.031]、血清钙≥2.65 mmol/L患者高于血清钙<2.65 mmol/L患者[1031.55(251.87,2115.98)比177.59(45.82,761.66),P=0.033]、hs-CRP≥3.3 mg/L患者高于hs-CRP<3.3 mg/L患者[487.40(141.38,1107.02)比63.44(19.40,634.31),P=0.003]、病灶数>3个患者高于病灶数≤3个患者[625.32(150.80,1134.35)比40.04(10.96,70.88),P<0.001]。不同临床特征组间最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))比较,差异均无统计学意义(均P>0.05)。结论^(18)F-FDG PET-CT代谢参数中MTV和TLG指标较SUV_(max)、SUV_(mean)能更好地反映MM患者的临床特征。

Objective To investigate the relationship between metabolic parameters of ^(18)F-FDG PET-CT and clinical characteristics in newly diagnosed patients with multiple myeloma(MM).Methods The clinical data of 47 MM patients who underwent ^(18)F-FDG PET-CT at initial diagnosis from June 2018 to December 2020 in the Second Affiliated Hospital of Anhui Medical University were retrospectively analyzed.The association of metabolic parameters of ^(18)F-FDG PET-CT with the following clinical parameters including age,gender,disease classification,DS stage,international staging system(ISS)stage,hemoglobin,albumin,serum calcium,serum crearinine,lactate dehydrogenase,β2-microglobulin,high-sensitivity C-reactive protein(hs-CRP),bone marrow plasma cell ratio,the number of lesions and extramedullary lesions.Results Among 47 MM patients,in terms of tumor metabolic volume(MTV),patients at DS stageⅢwas higher than those at stageⅠ-Ⅱ[172.88(42.69,391.55)vs.19.63(4.24,42.61),P<0.001],patients with serum calcium≥2.65 mmol/L was higher than those with serum calcium<2.65 mmol/L[310.71(99.68,549.62)vs.58.00(19.63,248.34),P=0.038],patients with hs-CRP≥3.3 mg/L was higher than those hs-CRP<3.3 mg/L[211.39(57.79,397.70)vs.35.34(7.91,153.02),P=0.002],and patients with the number of lesions>3 was higher than those with the number of lesions≤3[211.39(57.79,393.02)vs.16.43(5.12,38.23),P<0.001].In terms of total lesion glycolysis(TLG)value,patients at DS stageⅢwas higher than those at stageⅠ-Ⅱ[460.44(92.62,1113.85)vs.46.68(9.32,89.89),P=0.001],patients with bone marrow plasma cell ratio<10%was higher than those with bone marrow plasma cell ratio≥10%[1039.36(615.28,1167.80)vs.150.80(45.36,821.01),P=0.031],patients with serum calcium≥2.65 mmol/L was higher than those with serum calcium<2.65 mmol/L[1031.55(251.87,2115.98)vs.177.59(45.82,761.66),P=0.033],patients with hs-CRP≥3.3 mg/L was higher than those hs-CRP<3.3 mg/L[487.40(141.38,1107.02)vs.63.44(19.40,634.31),P=0.003],patients with lesion number>3 was higher than those with lesion number≤3[625.32(150.80,1134.35)vs.40.04(10.96,70.88),P<0.001].There were no statistically significant differences in the maximum standardized uptake value(SUV_(max))and mean standardized uptake value(SUV_(mean))among different clinical parameter groups(all P>0.05).Conclusion MTV and TLG in ^(18)F-FDG PET-CT metabolic parameters can better reflect the characteristics of MM patients compared with SUV_(max) and SUV_(mean).