Objective To evaluate the value of 18F-FDG PET/CT in histological grading and staging of follicular lymphoma (FL) and prediction of prognosis after first-line treatment.Methods From May 2007 to April 2013,24 patients (11 males,13 females; median age 55 years) with histopathological proof of FL were retrospectively studied.All patients were evaluated by 18F-FDG PET/CT before the first-line treatment and were divided into indolent FL and aggressive FL according to their histological grades and clinical stages.The sensitivity,specificity and SUVmax were calculated.Analysis of variance of factorial design was used to analyze the data.Within the same study period,18F-FDG PET/CT was also performed in 16 FL patients (9 males,7 females; median age 50.5 years) after first-line treatment (7/16 patients belonged to the aforementioned group with pretreatment PET/CT performed) ; and they were then divided into PET/CTpositive and PET/CT-negative groups.All 16 patients were followed for 6-49 months to evaluate the prognosis.The rates of overall survival (OS) and progression-free survival (PFS) were calculated.Results (1)The sensitivities of PET/CT in indolent and aggressive FL were 92.3％ (12/13) and 100％ (11/11),respectively.The SUVmax was 5.26± 1.70 vs 9.54±5.09 (F=5.196,P＜0.05).(2) According to PET/CT,3patients(12.5％,3/24) were upstaged from Ⅰ-Ⅱ to Ⅲ-Ⅳ,and 2 patients(8.3％,2/24) were downstaged from Ⅲ-Ⅳ to Ⅰ-Ⅱ.The SUVmax of stage Ⅰ-Ⅱ and Ⅲ-Ⅳ FL was 5.22±2.92 and 8.04±4.46(F=2.904,P＞0.05).(3)For the 16 FL patients with PET/CT after first-line treatment,the negative and positive groups had different OS and PFS.The 6-month OS,1-year OS and 3-year OS were 100％(13/13),9/9,4/5,respectively for the negative group,and 2/3,2/3,1/2,respectively for the positive group; while the corresponding 6-month PFS,1-year PFS and 3-year PFS were 92.3 ％ (12/13),8/9,3/5 and 2/3,0/3,0/2,respectively.Conclusions 18F-FDG PET/CT is valuable in the evaluation of histological grading and clinical staging of FL patients and in the prediction of prognosis after fist-line treatment.%目的 探讨18F-FDG PET/CT对治疗前不同组织学分级及不同临床分期的滤泡性淋巴瘤(FL)的诊断价值,及其对一线治疗后的预后评估作用.方法 回顾性分析2007年5月至2013年4月经病理学证实的24例(男11例,女13例,中位年龄55岁)治疗前行18F-FDG PET/CT显像的FL患者.将患者按不同组织学分级和临床分期进行分组,计算对各组的诊断效能,并采用析因设计的方差分析比较不同组患者的病灶SUVm..将同期一线治疗后行18F-FDG PET/CF显像的16例[男9例,女7例,中位年龄50.5岁；其中7例为前述治疗前也行显像的患者]按照PET/CT结果分为阳性组和阴性组,对患者进行随访(6～49个月)并评价预后.结果 (1)24例患者中惰性FL(组织学分级1±2级)13例,侵袭性FL 11例(组织学分级3级及2级伴DLBCL转化).PET/CT显像诊断惰性FL和侵袭性FL患者的灵敏度分别为92.3％(12/13)和100％(11/11)；SUVmax分别为5.26± 1.70和9.54±5.09(F=5.196,P＜0.05)；(2)PET/CT将Ann Arbor分期为Ⅰ～Ⅱ期3例患者(12.5％,3/24)上调至Ⅲ～Ⅳ期,将2例患者(8.3％,2/24)的分期由Ⅲ～Ⅳ期下调至Ⅰ～Ⅱ期.Ⅰ～Ⅱ期和Ⅲ～Ⅳ期患者的SUVmax分别为5.22±2.92和8.04±4.46(F=2.904,P＞0.05)；(3)16例一线治疗后行PET/CT显像的FL患者中,PET/CT阴性和阳性患者分别为13和3例,2组6个月、1年及3年总生存率分别为100％(13/13)、9/9、4/5和2/3、2/3和1/2；无进展生存率分别为92.3％(12/13)、8/9、3/5和2/3、0/3和0/2.结论 18F-FDG PET/CT对治疗前不同组织学分级及不同临床分期的FL有较高的诊断价值.FL患者一线治疗后行18F-FDG PET/CT检查可提示预后.
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