预处理18F-FDG PET/CT成像代谢参数对早期结外自然杀伤/T细胞淋巴瘤患者的预后价值

中华核医学与分子影像杂志 Pub Date : 2019-12-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.12.006

B. Tang, Jin Zhou, Zhe Guo, Tiannyu Li, C. Ding

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引用次数: 0

摘要

目的探讨18f -氟脱氧葡萄糖(FDG)预处理PET/CT图像代谢参数对Ⅰ-Ⅱ期结外自然杀伤/T细胞淋巴瘤(ENKTL)患者预后的价值。方法2010年8月至2018年4月对67例Ⅰ-Ⅱ期ENKTL患者(男47例，女20例;回顾性分析南京医科大学第一附属医院临床资料及18F-FDG预处理PET/CT影像资料。根据PET/CT图像计算肿瘤组织的代谢肿瘤体积(MTV)和病变总糖酵解(TLG)，阈值为最大标准化摄取值(SUVmax)的40%。采用受试者工作特征(ROC)曲线分析SUVmax、MTV和TLG的无进展生存期(PFS)和总生存期(OS)的最佳临界值。采用Kaplan-Meier法、log-rank检验和Cox比例风险模型进行数据分析。结果67例患者的SUVmax、MTV、TLG分别为12.32(8.65、16.96)、13.13(7.37、22.74)ml、92.17(46.54、198.46)ml。ROC曲线分析显示，SUVmax、MTV和TLG的临界值分别为13.09、18.05 ml和152.81。单因素分析显示，B症状、乳酸脱氢酶(LDH)水平、β2微球蛋白、东部肿瘤合作组(ECOG)评分、韩国预后指数(KPI)、SUVmax、MTV、TLG、治疗方式(化疗或放化疗)是影响PFS的相关因素(χ2: 5.466 ~ 27.163，均P 0.05)。多因素分析显示，ECOG评分、MTV、TLG是PFS的独立预测因子(相对比RR: 5.107 ~ 6.802，均P<0.05)， ECOG评分、MTV、TLG、治疗方式是OS的独立预测因子(相对比RR: 0.221 ~ 9.106，均P<0.05)。结论预处理18F-FDG PET/CT影像MTV和TLG是Ⅰ-Ⅱ期ENKTL患者PFS和OS的独立预后因素。对于预后，MTV和TLG可能比SUVmax更有用。关键词:淋巴瘤，结外NK-T细胞;正电子发射断层扫描;断层扫描，x射线计算机;脱氧葡萄糖

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Prognostic value of pretreatment 18F-FDG PET/CT imaging metabolic parameters in patients with early-stage extranodal natural killer/T cell lymphoma

Objective To investigate the prognostic value of metabolic parameters calculated from pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT images in patients with extranodal natural killer/T cell lymphoma (ENKTL) of stage Ⅰ-Ⅱ. Methods From August 2010 to April 2018, 67 patients with ENKTL of stage Ⅰ-Ⅱ disease (47 males, 20 females; median age 57 years) in the First Affiliated Hospital of Nanjing Medical University were enrolled, and the clinic data and pretreatment 18F-FDG PET/CT imaging data were retrospectively analyzed. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of tumor tissue were calculated from PET/CT images with the threshold value of 40% of maximum standardized uptake value (SUVmax). The optimal cut-off values of progression-free survival (PFS) and overall survival (OS) of SUVmax, MTV and TLG were investigated by using receiver operating characteristic (ROC) curve analysis. Kaplan-Meier method, log-rank test and Cox proportional hazards model were used for data analysis. Results SUVmax, MTV and TLG of 67 patients were 12.32(8.65, 16.96), 13.13(7.37, 22.74) ml, 92.17(46.54, 198.46), respectively. ROC curve analysis showed that the cut-off values of SUVmax, MTV and TLG were 13.09, 18.05 ml and 152.81, respectively. Univariate analysis showed that B symptoms, lactate dehydrogenase (LDH) level, β2-microglobulin, Eastern Cooperative Oncology Group (ECOG) score, Korean prognostic index (KPI), SUVmax, MTV, TLG and treatment mode (chemotherapy or chemoradiotherapy) were relative factors affecting PFS (χ2: 5.466-27.163, all P 0.05). Multivariate analysis showed that ECOG score, MTV and TLG were independent prognostic predictors of PFS (relative ratio (RR): 5.107-6.802, all P<0.05), and ECOG score, MTV, TLG and treatment mode were independent prognostic predictors of OS (RR: 0.221-9.106, all P<0.05). Conclusions MTV and TLG from pretreatment 18F-FDG PET/CT images are independent prognostic factors for PFS and OS in patients with ENKTL of stage Ⅰ-Ⅱ. MTV and TLG may be more useful than SUVmax for prognosis. Key words: Lymphoma, extranodal NK-T cell; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.