^(18)F-FDG PET/CT预测弥漫大B细胞淋巴瘤化疗后无进展生存期

^(18)F-FDG PET/CT Prognostic Role in Diffuse Large B-cell Lymphoma Following Chemotherapy

[目的]评估^(18)F-FDG PET/CT不同代谢参数在分析弥漫性大B细胞淋巴瘤(DLBCL)治疗响应中的预测价值。[方法]回顾性地选取2015年6月至2020年10月收治^(18)F-FDG PET/CT的81例DLBCL患者。通过多元逻辑回归分析确定DLBCL治疗反应的预测因素,并根据这些因素创建预测模型。之后,通过特性曲线和校准图验证此预测模型的性能。[结果]首次化疗后2年内,23例患者(28.3%,23/81)疾病复发,58例患者(71.7%,58/81)无进展。本文分析了PET/CT特征的二元逻辑回归模型的预测能力。结果显示,化疗后^(18)F-FDG PET/CT的定量值是无进展生存期(PFS)的独立预后因素。其中,SUV_(THR-mean)2是预测DLBCL患者化疗后治疗反应的最重要因素,临界值为2.00(AUC=0.81)。[结论]我们建立的影像学特征预测模型显示出对DLBCL化疗无进展生存期的良好预测效能。其中,化疗后的影像学特征SUV_(THR-mean)2是DLBCL患者PSF预后的最佳独立预测因素。我们的预测模型将能提示疾病进展风险,有利于建议临床选择适当的治疗及随访方案,提高诊治效能,节省医疗成本。

[Objective]To assess the prognostic value of ^(18)F-FDG PET/CT parameters for predicting therapeutic re⁃sponse in diffuse large B-cell lymphoma(DLBCL).[Methods]We retrospectively analyzed the clinical data and ^(18)F-FDG PET/CT radiomics features of 81 DLBCL patients enrolled between June 2015 and October 2020.Multivariate logistic re⁃gression analysis was used to identify the predictive factors for therapeutic response of DLBCL,based on which a predic⁃tive model was developed accordingly.The performance of the model was evaluated by receiver operating characteristic(ROC)curves and calibration plots.[Results]During the two years after first chemotherapy,23 patients(28.3%)devel⁃oped relapse and 58 patients(71.7%)had progression-free survival(PFS).The analysis for the predictive capability of the binary logistic regression model incorporating the PET/CT features revealed that the imaging features of ^(18)F-FDG PET/CT after chemotherapy were independent prognostic factors for PFS.Among them,SUV_(THR-mean)2 was the most important fac⁃tor for predicting therapeutic response in DLBCL patients after chemotherapy,with a cutoff value of 2.00(AUC=0.81).[Conclusions]^(18)F-FDG PET/CT showed a valuable prognostic performance for PFS in DLBCL patients after chemothera⁃py,with the imaging feature after chemotherapy SUV_(TLR-mean)2 being the optimal independent predictor.Our predictive mod⁃el of imaging features might have an important prognostic value in assessing the risk of disease progression,guiding the treatment and follow-up protocol,improving therapeutic efficiency and cutting down the medical cost.