18F-FDG PET/CT对B细胞淋巴瘤相关噬血细胞综合征患者的临床价值

摘要

Objective:To investigate the clinical value of 18F-FDG PET/CT for patients with B cell lymphoma-associated hemophagocytic syndrome.Methods:The clinical characteristics,laboratory parameters and 18F-FDG PET/CT data of 23 newly diagnosed patients sufferred from B cell lymphoma-associated hemophagocytic syndrome were retrospectively analyzed.The correlation between PET and laboratory parameters were determined using Spearman correlation test.The prognostic factors were analyzed by the Kaplan-Meier method.Results:23 patients were all examined by 18F-FDG PET/CT before chemotherapy,the 18F-FDG uptake of spleen positively correlated with neutrophil count and hemoglobin content (r =0.588,P =0.035;r =0.699,P =0.008),respectively,and the 18 F-FDG uptake of bone marrow positively correlated with neutrophil count only (r =0.691,P =0.009).Among all the clinical or laboratorial parameters and 18F-FDG PET/CT,only PET parameter was poor factor affecting prognosis of patients with B cell lymphoma-associated hemophagocytic syndrome.Out of 6 patients received PET/CT scans after 6 cycles of treatment,the 5 patients with negative PET/CT survived,and one patient with positive result died.Conclusion:Baseline 18 F-FDG PET/CT may provide prognostic information for the management of patients with B cell lymphoma-associated hemophagocytic syndrome,and the data of 18F-FDG PET/CT before chemotherapy may predict the pregnosis of the patients with negative results,and the negative PET/CT results after chemotherapy betokens a better prognosis of patients.%目的:探讨18 F-FDG PET/CT在B细胞淋巴瘤相关噬血细胞综合征的临床应用价值.方法:回顾性分析23例确诊的B细胞淋巴瘤相关噬血细胞综合征患者的临床特点、实验室指标及18 F-FDG PET/CT显像资料.对PET参数与各实验室指标的相关性采用Spearman检验,对影响生存的不同因素采用Kaplan-Meier法分析.结果:23例患者于化疗前均行18F-FDG PET/CT检查,脾脏的18F-FDG摄取只与中性粒细胞计数及血红蛋白含量具有相关性(r =0.588,P=0.035;r =0.699,P=0.008),而骨髓的18F-FDG摄取仅与中性粒细胞计数具有相关性(r=0.691,P=0.009);在所有的临床特点、实验室指标及18 F-FDG PET/CT检查参数中,只有PET参数是影响B细胞淋巴瘤相关噬血细胞综合征预后的不良因素.6例患者于化疗6周期后行第2次18 F-FDG PET/CT检查,化疗后PET/CT结果阴性患者5例,无1例死亡;化疗后PET/CT检测结果阳性患者1例,治疗无效死亡.结论:化疗前18F-FDGPET/CT检测能够预测B细胞淋巴瘤相关噬血细胞综合征的预后,化疗后PET/CT检测结果阴性预示患者有较好的预后.