基线^(18)F-FDG PET/CT代谢参数对侵袭性非霍奇金淋巴瘤的治疗反应和预后的作用

Role of baseline ^(18)F-FDG PET/CT metabolic parameters in the treatment response and prognosis of invasive non-Hodgkin′s lymphoma

目的:探讨基线18氟氟代脱氧葡萄糖-正电子发射计算机断层显像(^(18)F-FDG PET/CT)代谢参数对侵袭性非霍金淋巴瘤(NHL)的治疗反应和预后的作用。方法:回顾性分析101例侵袭性NHL病人的临床资料,所有病人均接受CHOP样方案化疗及^(18)F-FDG PET/CT检查,根据治疗反应将病人分为完全反应组63例、部分反应组22例和无反应组16例,另根据预后将病人分为预后良好组66例、预后不良组35例,比较不同治疗反应、预后病人基线^(18)F-FDG PET/CT代谢参数[最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、总糖酵解量(TLG)],采用受试者工作特征曲线(ROC)分析基线^(18)F-FDG PET/CT代谢参数联合检测对侵袭性NHL治疗反应和预后的预测价值。结果:不同治疗反应侵袭性NHL病人基线SUVmax、MTV、TLG水平存在明显差异(F=37.38、22.20、17.16,P<0.05);其中,完全反应组、部分反应组基线SUVmax、MTV、TLG水平低于无反应组,且完全反应组水平低于部分反应组水平(P<0.05)。预后良好组基线SUVmax、MTV、TLG水平低于预后不良组(t=6.49、6.02、5.48,P<0.05)。ROC曲线显示,基线SUVmax、MTV、TLG对侵袭性NHL治疗反应和预后具有一定预测价值(AUC=0.791、0.792、0.797,0.792、0.790、0.791,P<0.01),且联合检测(AUC=0.853、0.846,P<0.01)预测价值较高。结论:联合检测基线SUVmax、MTV、TLG等^(18)F-FDG PET/CT代谢参数对侵袭性NHL治疗反应和预后具有较高预测价值。

Objective:To explore the role of baseline 18fluorfluoride deoxyglucose-positron emission tomography/computed tomography(^(18)F-FDG PET/CT)metabolic parameters on the treatment response and outcome of invasive non-Hodgkin′s lymphoma(NHL).Methods:The clinical data of 101 patients with invasive NHL were retrospectively analyzed.All patients received chemotherapy with the R-CHOP regimen and ^(18)F-FDG PET/CT examination.According to the treatment response,the patients were divided into the complete response group(63 cases),partial response group(22 cases)and non-response group(16 cases),In addition,according to the prognosis,the patients were divided into the good prognosis(66 cases)and poor prognosis(35 cases).The treatment response and baseline ^(18)F-FDG PET/CT metabolic parameters[including the maximum standardized uptake value(SUVmax),tumor metabolic volume(MTV)and total glycolysis(TLG)]were compared among all groups.The predictive value of the baseline ^(18)F-FDG PET/CT metabolic parameters on treatment response and outcome of invasive NHL were analyzed using the receiver operating characteristic(ROC)curve.Results:The differences of the baseline SUVmax,MTV,and TLG among the invasive NHL patients with different treatment response were statistically significant(F=37.38,22.20 and 17.16,P<0.05).The baseline SUVmax,MTV,and TLG in complete response group and partial response group were lower than those in non-response group,and which in the complete response group was lower than that in partial response group(P<0.05).The baseline SUVmax,MTV,and TLG levels in the good prognosis group were lower than those in poor prognosis group(t=6.49,6.02 and 5.48,P<0.05).The results of ROC curve showed that the baseline SUVmax,MTV,and TLG had high predictive value for treatment response and prognosis of invasive NHL(AUC=0.791,0.792,0.797,0.792,0.790,0.791,P<0.01),and the predictive value of combined detection was higher(AUC=0.853,0.846,P<0.01).Conclusions:The[^(18)F]FDG-PET/CT)metabolic parameters(combined detection baseline SUVmax,MTV,TLG)have high predictive value on the treatment response and prognosis of invasive NHL.