论文部分内容阅读
【目的】结合多发性骨髓瘤国际分期系统,初步探讨~(18)F-FDG PET/CT显像对初诊多发性骨髓瘤患者的临床应用。【方法】选取2012年12月至2015年12月中山大学肿瘤医院共54例临床新近诊断多发性骨髓瘤并治疗前进行~(18)F-FDG PET/CT显像病例,按国际分期系统(ISS及R-ISS)进行分期,并按1按病灶放射性浓聚最高层面测量SUVmax为SUVmax≥4组及SUVmax<4组;2按FLs数量分为FLs<3、FLs≥3及弥漫病灶分组;3按有无溶骨性破坏分为骨质破坏组及无骨质破坏组;4按病变区是否有软组织肿块分为有软组织肿块组及无软组织肿块组;5按有无髓外病变分为有EMD组及无EMD组进行分组;分析~(18)F-FDG PET/CT显像结果与国际分期的相关性。【结果】54例多发性骨髓瘤中,ISSⅠ期12例、ISSⅡ期18例、ISSⅢ期24例。33例行染色体检测患者中,R-ISSⅠ期5例、Ⅱ期6例、Ⅲ期22例。局限性病灶与弥漫病灶在ISSⅠ、Ⅱ组与ISSⅢ组及ISSⅠ组与Ⅱ、Ⅲ组间差异均有统计学意义(P=0.044及0.004)。局限性病灶<3与局限性病灶≥3及弥漫病灶组在ISSⅠ组与Ⅱ、Ⅲ组差异有统计学意义(P=0.007)。有无软组织肿块在ISSⅠ组与Ⅱ、Ⅲ组间差异有统计学意义(P=0.004)。有无髓外病变在ISSⅠ、Ⅱ组与ISSⅢ组间差异有统计学意义(P=0.002)。对比ISS及R-ISS分期,7例分期上调病例中6例为弥漫病灶。【结论】初诊MM患者~(18)F-FDG PET/CT浸润病灶的数量多少、是否有软组织肿块及是否有髓外病变的存在与患者ISS分期存在一定的相关性。初诊MM患者治疗前~(18)F-FDG PET/CT显像可为临床的病情评估及治疗方案的选择提供更多的依据。
【Objective】 To investigate the clinical application of ~ (18) F-FDG PET / CT in the diagnosis of newly diagnosed multiple myeloma combined with the international staging system of multiple myeloma. 【Methods】 A total of 54 clinical newly diagnosed multiple myeloma from December 2012 to December 2015 in Cancer Hospital of Sun Yat-sen University were selected and treated with ~ (18) F-FDG PET / CT imaging before treatment. According to the international staging system ISS and R-ISS). The SUVmax of SUVmax≥4 and SUVmax <4 were measured according to the highest level of radioactive accumulation of lesions. 2 The FLs were divided into three groups according to FLs: FLs <3, FLs≥3 and diffuse lesions group. 3 according to the presence of osteolytic destruction is divided into bone destruction group and no bone destruction group; 4 by the lesion area if there are soft tissue mass into soft tissue mass group and no soft tissue mass group; 5 by extramedullary lesions were divided into Patients with EMD and without EMD were divided into groups. The correlation between ~ (18) F-FDG PET / CT findings and international staging was analyzed. 【Results】 Of the 54 patients with multiple myeloma, 12 were ISSⅠ, 18 were ISⅡ, and 24 were ISSⅢ. Of 33 patients with chromosomal detection, R-ISS stage Ⅰ 5 cases, stage Ⅱ 6 cases, stage Ⅲ 22 cases. The difference between focal lesions and diffuse lesions was statistically significant (P = 0.044 and 0.004) between ISSⅠ, Ⅱand ISSⅢand ISSⅠand Ⅱ, Ⅲgroups. There was a significant difference between ISSⅠand Ⅱ, Ⅲgroups of focal lesion <3 and focal lesion≥3 and diffuse lesion group (P = 0.007). The presence or absence of soft tissue mass in ISS Ⅰ group and Ⅱ, Ⅲ difference between the groups was statistically significant (P = 0.004). The presence or absence of extramedullary lesions in the ISS Ⅰ, Ⅱ and ISS Ⅲ group difference was statistically significant (P = 0.002). Compared with ISS and R-ISS staging, 6 of 7 cases were up-staged with diffuse lesions. 【Conclusion】 The number of infiltrated lesions of ~ (18) F-FDG PET / CT in patients with newly diagnosed MM has some correlation with the presence of soft tissue mass and extramedullary lesions and ISS staging of patients. Early treatment of MM patients before treatment ~ (18) F-FDG PET / CT imaging for clinical evaluation of the disease and treatment options to provide more basis.