化疗前及中期PET/CT标准摄取值对淋巴瘤的预后价值

摘要

Purpose: To discuss the the prognostic value of pre-therapy and interim 18F-FDG PET/CT SUVmax in patients with diffuse large B-cell lymphoma(DLBCL). Methods: Thirty-seven patients with pathologically confirmed DLBCL accepted PET/CT imaging before and after 2-4 courses of chemotherapy. The relevance between Ki67 and SUVmax was calculated. Cases were divided into different groups depending on staging, international prognostic index(IPI), therapy outcomes and relapse or not. Average values of groups were compared, and the Kaplan-Meier analysis of progression free survivals(PFS) based on optimum cutoffs calculated by ROC curve were undertaken. Results: 1. Positive correlation was revealed between Ki67 proliferative index and SUVmax (P=0.002). 2.There were no statistical differences of SUVOmax between groups. 3. DLBCL patients with stage IV and high IPI revealed higher SUV2-4max(P=0.015 and 0.007 respectively); relapsers also showed higher SUV2-4max although the difference was of no significance(P=0.067). The optimum cutoff of SUV2-4max was 3.05, and bipartite groups based on this value took no significant difference in. the aspect of PFS. 4.DLBCL patients with stage IV, high IPI, and relapse showed lower △ SUVmax and △SUVmax% (,P=0.009, 0.002 and 0.022 respectively). The optimum cutoffs were 3.6 and 44.9% respectively. The patients with △SUVmax≤3.6 and △SUVmax%≤44.9% showed shorter PFS, and the latter one was of greater significance. Conclusion: Ki67 and SUVmax were positively correlated. △SUVmax and △SUVmax% might be more valuable than SUV2-4max in prognosis of DLBCL patients, and △SUVmax% seemed to be better. SUVOmax were unlikely to provide effective prognostic information.%目的:探讨化疗前及化疗中期18F-FDG PET/CT显像SUV最大值(SUVmax)对弥漫大B细胞淋巴瘤(DLBCL)患者预后的价值.方法:37例病理证实的DLBCL患者,化疗前及2～4个疗程化疗后行PET/CT检查,计算Ki67与SUVmax的关系,按分期、国际预后指数(IPI)、疗效及复发与否分组,比较均值、计算最佳临界值并行生存分析.结果:①Ki67和SUVmax正相关(P=0.002).②各组SUV0max无显著差异.③Ⅳ期、IPI高危组SUV2～4max高于其他组(P=0.015、0.007)；复发组SUV2～4max高于未复发组,但无统计学差异；SUV2～4max最佳临界值为3.05,以该值分组的PFS无统计学差异.④Ⅳ期、IPI高危及复发组△SUVmax及△SUVmax％均较低(P=0.009、0.002、0.022),△SUVmax≤3.6和△SUVmax％≤44.9％者PFS较短,且后者差异更显著(P=0.028、0.006).结论:SUVmax与Ki67正相关；△SUVmax和△SUVmax％的预后价值高于SUV2～4max,且以后者更佳.