Objective: High-dose chemotherapy(HDC) followed by autologous hematopoietic stem cell transplantation(auto-HSCT) plays an important role in improving outcomes of diffuse large B cell lymphoma(DLBCL) patients.18 F-fluo...Objective: High-dose chemotherapy(HDC) followed by autologous hematopoietic stem cell transplantation(auto-HSCT) plays an important role in improving outcomes of diffuse large B cell lymphoma(DLBCL) patients.18 F-fluorodeoxyglucose(18 F-FDG) positron emission tomography(PET)/computed tomography(CT) has been widely accepted in response assessment and prediction of prognosis in DLBCL. Here, we report the value of 18 FFDG PET/CT pre-and post-HSCT in predicting outcomes of patients with DLBCL.Methods: DLBCL patients who had PET/CT scan before and after HSCT were included. PET results were interpreted based upon Deauville criteria. The prognostic value of 18 F-FDG PET/CT in auto-HSCT was evaluated.Results: Eighty-four patients were enrolled. In univariate analysis, pre-and post-HSCT PET findings were correlated with 3-year progression-free survival(PFS) [hazard ratio(HR)=4.391, P=0.001; HR=7.607, P<0.001] and overall survival(OS)(HR=4.792, P=0.008; HR=26.138, P<0.001). Patients receiving upfront auto-HSCT after firstline treatment had better outcomes than relapsed/refractory DLBCL patients(3-year PFS, P<0.001; 3-year OS,P<0.001). In the relapsed/refractory patients, pre-and post-HSCT PET findings were also associated with 3-year PFS(P=0.003 vs. P<0.001) and OS(P=0.027 vs. P<0.001). A significant correlation was observed between clinical response to chemotherapy before auto-HSCT and outcomes of patients in the entire cohort(3-year PFS, P<0.001;3-year OS, P<0.001) and in the subgroup of 21 patients with positive pre-HSCT PET(3-year PFS, P=0.084; 3-year OS, P=0.240). A significant association between survival and post-HSCT PET findings was observed in multivariate analysis(HR=5.168, P<0.001).Conclusions: PET results before and after HSCT are useful prognostic factors for DLBCL patients receiving HSCT. Patients who responded to chemotherapy, even those with positive pre-HSCT PET, are appropriate candidates for auto-HSCT.展开更多
Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the crit...Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the criteria to interpret PET/CT results remain under debate.We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment(QVTA)criteria compared with the Deauvil e criteria.Methods:In this retrospective study,final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauvil e and QVTA criteria.Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.Results:A total of 253 patients were enrol ed.The interpretation according to the Deauvil e criteria revealed that 181patients had negative PET/CT scan results and 72 had positive results.The 3 year overal survival(OS)rate was significantly higher in patients with negative scan results than in those with positive results(91.6%vs.57.5%,P<0.001).The72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria:29 had indeterminate results,and 43 had positive results.The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results(91.2%vs.33.5%,P<0.001)but was similar between patients with negative and indeterminate scan results(91.6%vs.91.2%,P=0.921).Conclusions:Compared with the Deauvil e criteria,using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results.The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.展开更多
BACKGROUND Mucormycosis is a very rare fungal infection,and its prognosis is poor.Most common sites of infection are the sinuses,lung,or skin,and gastric involvement is uncommon.The standard antifungal therapy is the ...BACKGROUND Mucormycosis is a very rare fungal infection,and its prognosis is poor.Most common sites of infection are the sinuses,lung,or skin,and gastric involvement is uncommon.The standard antifungal therapy is the treatment of choice for gastric mucormycosis.However,the symptoms of gastric mucormycosis are varied and the early diagnosis is not easy.CASE SUMMARY I report a 53-year-old alcoholic man,who was admitted due to epigastric pain.The upper gastrointestinal endoscopy revealed a huge ulcer lesion in the stomach,which was suspected to be gastric cancer.F-18 fluorodeoxyglucose positron emission tomography/computed tomography(F-18 FDG PET/CT)showed diffusely intense FDG uptake at the ulcer lesion of the stomach,and several enlarged hypermetabolic lymph nodes were noted at the left gastric chain.Although,endoscopy and F-18 FDG PET/CT findings suggested advanced gastric cancer with regional lymph node metastases,there was no cancer cells in the biopsy results and multiple fungal hyphae were noted in the periodic acid-Schiff stained image.CONCLUSION He was diagnosed with gastric mucormycosis and successfully underwent amphotericin B and posaconazole treatment.展开更多
Intracranial metastasis of liver cancer is rare,and diplopia as the first manifestation is even more rare.This article aims to introduce a patient with sudden diplopia in a middle-aged man.Physical examination reveale...Intracranial metastasis of liver cancer is rare,and diplopia as the first manifestation is even more rare.This article aims to introduce a patient with sudden diplopia in a middle-aged man.Physical examination revealed left abductor nerve palsy,craniocerebral magnetic resonance imaging(MRI)showed intracranial metastatic tumor,and positron emission tomography-computer tomography(PET-CT)tracing of the original lesion detected the primary liver cancer.This paper provides clinical data for intracranial metastasis of primary liver cancer and the possible pathogenesis and mechanism of sudden diplopia.展开更多
基金supported by the National Natural Science Foundation of China (No. 81600164)
文摘Objective: High-dose chemotherapy(HDC) followed by autologous hematopoietic stem cell transplantation(auto-HSCT) plays an important role in improving outcomes of diffuse large B cell lymphoma(DLBCL) patients.18 F-fluorodeoxyglucose(18 F-FDG) positron emission tomography(PET)/computed tomography(CT) has been widely accepted in response assessment and prediction of prognosis in DLBCL. Here, we report the value of 18 FFDG PET/CT pre-and post-HSCT in predicting outcomes of patients with DLBCL.Methods: DLBCL patients who had PET/CT scan before and after HSCT were included. PET results were interpreted based upon Deauville criteria. The prognostic value of 18 F-FDG PET/CT in auto-HSCT was evaluated.Results: Eighty-four patients were enrolled. In univariate analysis, pre-and post-HSCT PET findings were correlated with 3-year progression-free survival(PFS) [hazard ratio(HR)=4.391, P=0.001; HR=7.607, P<0.001] and overall survival(OS)(HR=4.792, P=0.008; HR=26.138, P<0.001). Patients receiving upfront auto-HSCT after firstline treatment had better outcomes than relapsed/refractory DLBCL patients(3-year PFS, P<0.001; 3-year OS,P<0.001). In the relapsed/refractory patients, pre-and post-HSCT PET findings were also associated with 3-year PFS(P=0.003 vs. P<0.001) and OS(P=0.027 vs. P<0.001). A significant correlation was observed between clinical response to chemotherapy before auto-HSCT and outcomes of patients in the entire cohort(3-year PFS, P<0.001;3-year OS, P<0.001) and in the subgroup of 21 patients with positive pre-HSCT PET(3-year PFS, P=0.084; 3-year OS, P=0.240). A significant association between survival and post-HSCT PET findings was observed in multivariate analysis(HR=5.168, P<0.001).Conclusions: PET results before and after HSCT are useful prognostic factors for DLBCL patients receiving HSCT. Patients who responded to chemotherapy, even those with positive pre-HSCT PET, are appropriate candidates for auto-HSCT.
文摘Introduction:Fluorine-18 fluorodeoxyglucose(18F-FDG)positron emission tomography/computed tomography(PET/CT)is a powerful tool for monitoring the response of diffuse large B-cell lymphoma(DLBCL)to therapy,but the criteria to interpret PET/CT results remain under debate.We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment(QVTA)criteria compared with the Deauvil e criteria.Methods:In this retrospective study,final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauvil e and QVTA criteria.Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.Results:A total of 253 patients were enrol ed.The interpretation according to the Deauvil e criteria revealed that 181patients had negative PET/CT scan results and 72 had positive results.The 3 year overal survival(OS)rate was significantly higher in patients with negative scan results than in those with positive results(91.6%vs.57.5%,P<0.001).The72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria:29 had indeterminate results,and 43 had positive results.The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results(91.2%vs.33.5%,P<0.001)but was similar between patients with negative and indeterminate scan results(91.6%vs.91.2%,P=0.921).Conclusions:Compared with the Deauvil e criteria,using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results.The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.
基金Supported by National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIP),No.2017R1C1B5076640
文摘BACKGROUND Mucormycosis is a very rare fungal infection,and its prognosis is poor.Most common sites of infection are the sinuses,lung,or skin,and gastric involvement is uncommon.The standard antifungal therapy is the treatment of choice for gastric mucormycosis.However,the symptoms of gastric mucormycosis are varied and the early diagnosis is not easy.CASE SUMMARY I report a 53-year-old alcoholic man,who was admitted due to epigastric pain.The upper gastrointestinal endoscopy revealed a huge ulcer lesion in the stomach,which was suspected to be gastric cancer.F-18 fluorodeoxyglucose positron emission tomography/computed tomography(F-18 FDG PET/CT)showed diffusely intense FDG uptake at the ulcer lesion of the stomach,and several enlarged hypermetabolic lymph nodes were noted at the left gastric chain.Although,endoscopy and F-18 FDG PET/CT findings suggested advanced gastric cancer with regional lymph node metastases,there was no cancer cells in the biopsy results and multiple fungal hyphae were noted in the periodic acid-Schiff stained image.CONCLUSION He was diagnosed with gastric mucormycosis and successfully underwent amphotericin B and posaconazole treatment.
文摘Intracranial metastasis of liver cancer is rare,and diplopia as the first manifestation is even more rare.This article aims to introduce a patient with sudden diplopia in a middle-aged man.Physical examination revealed left abductor nerve palsy,craniocerebral magnetic resonance imaging(MRI)showed intracranial metastatic tumor,and positron emission tomography-computer tomography(PET-CT)tracing of the original lesion detected the primary liver cancer.This paper provides clinical data for intracranial metastasis of primary liver cancer and the possible pathogenesis and mechanism of sudden diplopia.
