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Received:December 09, 2021 Published Online:May 20, 2022
Received:December 09, 2021 Published Online:May 20, 2022
中文摘要: 目的 探究18氟-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT)代谢参数在黏膜相关淋巴组织(MALT)淋巴瘤中的临床应用价值。方法 回顾性分析南通大学附属医院2016年5月至2020年6月病理诊断为MALT淋巴瘤的38例患者临床资料;其中22例患者在完善基线PET/CT检查前未切除局部病灶,记录肿瘤代谢指标[肿瘤代谢体积(MTV)、糖酵解总量(TLG)、平均标准摄取值(SUVmean)、标准摄取值峰值(SUVpeak)];16例患者在治疗中期完善PET/CT Deauvile-5ps(DS)评分。统计分析PET/CT肿瘤代谢参数与MALT淋巴瘤临床特征及无进展生存期(PFS)、总体生存期(OS)的相关性及预后价值。结果 22例患者中,MTV在乳酸脱氢酶(LDH)和疾病原发部位,TLG在肿瘤分期、LDH、疾病原发部位,SUVmean、SUVpeak在肿瘤分期、β2微球蛋白、Ki-67和原发部位的不同分组间差异均有统计学意义(P<0.05)。MTV与B症状、LDH水平,TLG与B症状、国际预后评分(IPI评分)、β2微球蛋白水平、LDH水平及疾病原发部位,SUVmean与IPI评分及疾病原发部位,SUVpeak与疾病原发部位均呈显著相关性(P<0.05)。MTV、TLG、SUVmean、SUVpeak均与OS显著相关,而与PFS显著相关的只有TLG(P<0.05)。16例患者化疗中期复查PET/CT临床相关信息,并进行生存分析结果示,复查PET/CT阴性患者的PFS较阳性患者显著延长(P<0.05)。结论 PET/CT肿瘤代谢参数与MALT临床特征及PFS和OS有相关性,可以辅助用于临床诊断、疾病分期及预后评估。
Abstract:ObjectiveTo investigate the application of 18 fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) metabolic parameters in mucosa-associated lymphoid tissue(MALT) lymphoma. Methods The clinical data of 38 patients diagnosed with MALT lymphoma between May 2016 and June 2020 at Hospital of Nantong University were retrospectively analyzed; 22 of these patients had unresected local lesions before the baseline PET/CT was completed, and tumor metabolic indicators were taken, including tumor metabolic volume (MTV), total glycolysis (TLG), mean standardized uptake value (SUVmean), and peak standardized uptake value (SUVpeak). The PET/CT Deauvile-5ps (DS) score of 16 patients at mid-treatment was refined. The correlation between PET/CT tumor metabolic parameters and clinical characteristics, progression-free survival(PFS) and overall survival(OS) of MALT lymphoma and their predictive value was assessed. Results Among the 22 patients, MTV was significantly different in LDH and primary site subgroups; TLG was significantly different in tumor stage, LDH, and primary site subgroups; SUVmean was significantly different among different subgroups of tumor stage, β2 microglobulin, Ki-67, and primary site respectively (P<0.05). The SUVpeak also differed significantly between different subgroups for tumor stage, β2 microglobulin, Ki-67 and primary site (P<0.05). MTV was significantly different in the presence/absence of B symptoms and LDH; TLG was significantly different in B symptoms, IPI score, β2 microglobulin, LDH and site of disease; and TLG was significantly positively correlated with MTV (P<0.05). SUVmean was significantly correlated with IPI score and disease site (P<0.05). There was a significant correlation between SUVpeak and disease location (P<0.05). MTV, TLG, SUVmean, and SUVpeak were significantly correlated with OS, all with statistically significant differences (P<0.05). And only TLG was significantly associated with PFS (P<0.05). In this study, we also obtained clinically relevant information on mid-chemotherapy review PET/CT in 16 patients, and the results of survival analysis showed that PFS was significantly prolonged in patients with negative review PET/CT than in positive patients (P<0.05). Conclusions PET/CT tumor metabolic parameters were correlated with clincial feature, PFS and OS in patients with MALT lymphoma, which could assist in clinical diagnosis, disease staging and prognosis evaluation.
keywords: MALT lymphoma Positron emission tomography/computed tomography Tumor metabolic parameters Prognosis Lactate dehydrogenase Progression-free survival Overall survival
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基金项目:国家自然科学基金(81570184);南通市科技项目(MS22018008,MS12017003-2);中国博士后科学基金(2019M660127);江苏省博士后科研资助项目(2019K062,2019Z146)
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