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18F-FDG PET/CT参数SUVpeak、全身代谢肿瘤体积和总糖酵解值对弥漫大B细胞淋巴瘤患者预后的预测价值

翟威豪 何薇

翟威豪, 何薇. 18F-FDG PET/CT参数SUVpeak、全身代谢肿瘤体积和总糖酵解值对弥漫大B细胞淋巴瘤患者预后的预测价值[J]. 分子影像学杂志, 2021, 44(5): 787-791. doi: 10.12122/j.issn.1674-4500.2021.05.11
引用本文: 翟威豪, 何薇. 18F-FDG PET/CT参数SUVpeak、全身代谢肿瘤体积和总糖酵解值对弥漫大B细胞淋巴瘤患者预后的预测价值[J]. 分子影像学杂志, 2021, 44(5): 787-791. doi: 10.12122/j.issn.1674-4500.2021.05.11
ZHAI Weihao, HE Wei. Predictive value of 18F-FDG PET/CT quantization parameters SUVpeak, MTV and TLG in patients with diffuse large B-cell lymphoma[J]. Journal of Molecular Imaging, 2021, 44(5): 787-791. doi: 10.12122/j.issn.1674-4500.2021.05.11
Citation: ZHAI Weihao, HE Wei. Predictive value of 18F-FDG PET/CT quantization parameters SUVpeak, MTV and TLG in patients with diffuse large B-cell lymphoma[J]. Journal of Molecular Imaging, 2021, 44(5): 787-791. doi: 10.12122/j.issn.1674-4500.2021.05.11

18F-FDG PET/CT参数SUVpeak、全身代谢肿瘤体积和总糖酵解值对弥漫大B细胞淋巴瘤患者预后的预测价值

doi: 10.12122/j.issn.1674-4500.2021.05.11
基金项目: 

上海市科委“科技创新行动计划”产学研医合作领域项目 19DZ1910302

详细信息
    作者简介:

    翟威豪,技师,E-mail: weihaozhai@hotmail.com

    通讯作者:

    何薇,主任医师,E-mail: heweixu@hotmail.com

Predictive value of 18F-FDG PET/CT quantization parameters SUVpeak, MTV and TLG in patients with diffuse large B-cell lymphoma

  • 摘要:   目的  探讨化疗前PET/CT检查的SUVpeak、代谢肿瘤体积(MTV)、总糖酵解值(TLG)是否可以预测弥漫大B细胞淋巴瘤患者的预后。  方法  回顾性分析2011年8月~2018年11月本院诊治的76例弥漫大B细胞淋巴瘤患者资料,根据随访  结果  将患者分为进展组(n=40)和未进展组(n=36)、死亡组(n=6)和存活组(n=70)。所有患者化疗前均接受18F-FDG PET/CT检查,使用自动感兴趣区勾画软件测量记录病灶的SUVmax、SUVpeak、MTV、TLG等参数。比较疾病进展组和未进展组之间、死亡组和存活组之间PET参数的差异,通过ROC曲线求取PET参数的最佳临界值,并采用Kaplan-Meier生存分析比较生存率,使用临床变量资料和PET参数对生存期和疾病进展进行单因素和多因素分析。  结果  疾病进展组的中位SUVmax、SUVpeak、MTV和TLG分别为30.82(12.64~71.16)、19.89(9.35~52.23)、786.49(135.06~8795.16)cm3、4618.76(653.88~37361.18);未进展组为34.53(3.82~52.41)、15.76(3.18~32.37)、116.05(54.14~2642.96)cm3、420.18(276.97~9409.09)。进展组和未进展组之间SUVpeak、MTV及TLG差异有统计学意义(P < 0.05)。死亡组的中位数SUVmax、SUVpeak、MTV和TLG分别为50.47(19.95~130.14)、37.40(16.95~82.63)、2195.11(231.85~8361.82)cm3、14712.77(3371.5~28302.65);存活组为30.82(3.82~52.41)、19.43(3.18~38.62)、252.10(54.14~ 8795.16)cm3,1219.53(276.97~37361.18)。死亡组和存活组之间SUVmax、SUVpeak、MTV及TLG数值的差异均有统计学意义(P < 0.05)。患者SUVpeak、MTV和TLG小于临界值时患者生存率明显高于其大于临界值时。SUVpeak、MTV、TLG及国际预后指数评分与无进展生存期呈显著相关。  结论  SUVpeak、MTV和TLG均能在弥漫大B细胞淋巴瘤患者的治疗预后中提供重要的预测价值。

     

  • 图  1  使用感兴趣自动勾画软件处理FDG PET/CT图像

    Figure  1.  Process FDG PET/CT images by an SUV-based automated contouring program.

    图  2  软件自动生成淋巴瘤病灶的PET参数

    Figure  2.  Automatically generate quantitative parameters of lesions.

    表  1  DLBCL患者临床特征

    Table  1.   Patient characteristics

    特征 n (%)
    性別
      男 54(71.05)
      女 22(28.95)
    Ann Arbor分期
      Ⅰ 5(6.58)
      Ⅱ 8(10.53)
      Ⅲ 16(21.05)
      Ⅳ 47(61.84)
    IPI评分
      0~1 15(19.74)
      2~5 61(80.26)
    亚型
      GCB 30 (39.47)
      non-GCB 46 (60.53)
    IPI: 国际预后指数;GCB: 生发中心来源; DLBCL: 弥漫大B细胞淋巴瘤
    下载: 导出CSV

    表  2  单变量回归分析

    Table  2.   Univariate Cox proportional hazard regression analysis

    因素 HR 95%CI P
    SUVmax 1.049 0.976~1.133 0.254
    GCB 0.917 0.522~1.612 0.665
    Non-GCB 1.101 0.943~1.118 0.398
    SUVpeak 1.036 1.018~1.067 0.032
    GCB 1.024 1.013~1.047 0.024
    Non-GCB 1.045 1.012~1.089 0.040
    MTV 1.032 1.014~1.046 < 0.001
    GCB 1.028 1.008~1.043 0.016
    Non-GCB 1.082 1.056~1.123 0.002
    TLG 1.078 1.040~1.082 < 0.001
    GCB 1.090 1.031~1.142 0.007
    Non-GCB 1.112 1.078~1.182 0.004
    IPI 1.580 1.247~2.089 0.005
    LDH 1.003 0.988~1.012 0.223
    Ki-67 0.814 0.091~6.122 0.782
    MTV:代谢肿瘤体积;TLG:总糖酵解值;LDH:乳酸脱氢酶.
    下载: 导出CSV

    表  3  多变量回归分析

    Table  3.   Multivariate Cox proportional hazard regression analysis

    因素 HR 95%CI P
    SUVmax 1.042 0.982~1.121 0.244
    SUVpeak 1.025 1.011~1.046 0.028
    MTV 1.064 1.035~1.102 0.001
    TLG 1.088 1.040~1.082 0.001
    下载: 导出CSV
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  • 收稿日期:  2021-07-29
  • 刊出日期:  2021-09-20

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