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目的:评估治疗前18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像(18F-FDG-PET)/CT的最大标化摄取值(SUVmax)对弥漫大B细胞淋巴瘤(DLBCL)预后预测价值。方法:回顾分析76例新发DLBCL患者初次PET/CT检查中最大SUVmax与疾病分期、乳酸脱氢酶(LDH)、校正国际预后指数(R-IPI)等预后因素之间的相关性以及预后分析。结果:初发DLBL患者PET/CT的SUVmax与疾病分期、B症状、LDH、β2微球蛋白(β2-MG)、美国东部肿瘤协作组(ECOG)评分呈正相关。R-IPI3个预后组中的SUVmax有显著区别,R-IPI预后差的一组SUVmax均值明显高于前2组,有统计学意义(P<0.001)。SUVmax=10.25预测疾病进展的灵敏度和特异度分别是84.4%和68.2%。以此为标准分2组,SUVmax<10与SUVmax≥10组总有效率分别为87.9%和55.8%(P<0.05),3年PFS率分别是86.4%±6.4%和45.9%±9.8%(P=0.004),3年总生存(OS)率无统计学差异。经多因素Cox回归分析后显示IPI、LDH和SUVmax均为独立预后因素。结论:DLBCL患者治疗前PET/CT中FDG摄取强度可以预测患者的生存情况,SUVmax越低患者预后越好,反之,SUVmax越高患者预后越差。
PURPOSE: To evaluate the prognostic value of 18 F-FDG-PET / CT before treatment for prognosis of diffuse large B-cell lymphoma (DLBCL) value. Methods: The correlation between the maximum SUVmax and the prognosis of patients with newly diagnosed DLBCL in primary DLBCL and PET / CT was retrospectively analyzed. The prognosis of patients with DLBCL were analyzed retrospectively, including prognosis, age, disease status, lactate dehydrogenase (LDH), international prognostic index (R-IPI) . Results: SUVmax of PET / CT in newly diagnosed DLBL patients was positively correlated with disease stage, B symptoms, LDH, β2-MG and ECOG score. There was a significant difference in SUVmax among the three R-IPI prognostic groups. The mean SUVmax in the R-IPI with poor prognosis was significantly higher than the former two groups (P <0.001). SUVmax = 10.25 The sensitivity and specificity for predicting disease progression were 84.4% and 68.2%, respectively. The total effective rates of SUVmax <10 and SUVmax≥10 were 87.9% and 55.8%, respectively (P <0.05). The 3-year PFS rates were 86.4% ± 6.4% and 45.9% ± 9.8% P = 0.004), 3-year overall survival (OS) rate was not statistically different. After multivariate Cox regression analysis showed that IPI, LDH and SUVmax were independent prognostic factors. Conclusions: The FDG uptake intensity of PET / CT before DLBCL can predict the survival of patients. The lower the SUVmax, the better the prognosis of patients. Conversely, the higher the SUVmax, the worse the prognosis.