冯帆, 吴可, 张旭, 林晓平, 王彩琴, 王宇, 李志铭. 中期PET-CT检查在复发性弥漫大B细胞淋巴瘤预后分析中的作用[J]. 中国肿瘤临床, 2018, 45(16): 844-849. DOI: 10.3969/j.issn.1000-8179.2018.16.673
引用本文: 冯帆, 吴可, 张旭, 林晓平, 王彩琴, 王宇, 李志铭. 中期PET-CT检查在复发性弥漫大B细胞淋巴瘤预后分析中的作用[J]. 中国肿瘤临床, 2018, 45(16): 844-849. DOI: 10.3969/j.issn.1000-8179.2018.16.673
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Feng Fan, Wu Ke, Zhang Xu, Lin Xiaoping, Wang Caiqin, Wang Yu, Li Zhiming. The role of interim PET-CT in the prognostic analysis of relapsed diffuse large B cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(16): 844-849. DOI: 10.3969/j.issn.1000-8179.2018.16.673
Citation: Feng Fan, Wu Ke, Zhang Xu, Lin Xiaoping, Wang Caiqin, Wang Yu, Li Zhiming. The role of interim PET-CT in the prognostic analysis of relapsed diffuse large B cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2018, 45(16): 844-849. DOI: 10.3969/j.issn.1000-8179.2018.16.673
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中期PET-CT检查在复发性弥漫大B细胞淋巴瘤预后分析中的作用

The role of interim PET-CT in the prognostic analysis of relapsed diffuse large B cell lymphoma

    摘要
  • 摘要:
      目的  探讨中期正电子发射计算机断层显像（positron emission tomography-computed tomography，PET-CT）检查在复发性弥漫大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）中的作用。
      方法  回顾性分析2009年1月至2017年12月中山大学肿瘤防治中心收治的38例行中期PET-CT检查的复发性DLBCL患者临床病例资料，其中男性21例、女性17例。采用SPSS 20.0软件进行统计学分析。基线数据采用t、χ2检验或Fisher精确检验进行比较。生存数据应用寿命表、Kaplan-Meier法、Cox回归等方法进行分析。
      结果  全组患者中，中期PET-CT评价为有效组完全缓解（complete response，CR）+部分缓解（partial response，PR）和无效组疾病稳定（stable disease，SD）+疾病进展（progression of disease，PD）患者分别为30例和8例。全组患者的中位总生存期（median overall survival，mOS）和无进展生存期（progression free survival，PFS）分别为77.69和8.44个月。有效组和无效组的mOS分别为77.93和16.37个月（P=0.017）；有效组和无效组的中位PFS（median PFS，mPFS）分别为9.86个月和1.80个月（P=0.001）。单因素与多因素分析均显示，中期PET-CT评价为有效的患者获得更长的OS与PFS（P=0.006，P=0.001）。最大标准摄取值（maximum standard uptake value，SUVmax）≤11.05的患者获得更长的PFS和OS，ΔSUVmax>8和最大标准摄取值变化率（maximum standard uptake value %，ΔSUVmax%）>54.5%的患者仅表现出更长的PFS，OS则差异无统计学意义。
      结论  依照中期PET-CT结果分为有效组和无效组，按照临界值将SUVmax分组对复发性DLBCL患者的OS和PFS均有良好的预测作用，而按照临界值将ΔSUVmax、ΔSUVmax%分组能很好地预测复发性DLBCL患者的PFS。

     

    Abstract:
      Objective  To investigate the role of interim positron emission tomography- computed tomography (PET- CT) in patients with relapsed diffuse large B cell lymphoma (DLBCL).
      Methods  A total of 38 patients with recurrent DLBCL who underwent interim PET-CT examination from January 2009 to December 2017 in Sun Yat-sen University Cancer Center were enrolled in this retrospective study. The clinical data of the patients were analyzed. All of the statistical analyses were performed using SPSS version 20.0. Baseline characteristics were compared using t test, Chi-squared test, or Fisher's exact test. Survival data were analyzed using life tables, the Kaplan-Meier method, and Cox regression. A two-tailed P < 0.05 was considered to be statistically significant.
      Results  Thirty cases were included in the effective group (complete remission+partial remission) and 8 cases in the ineffective group (stable disease+progressive disease). The median overall survival (OS) and progression free survival (PFS) of all patients were 77.69 months and 8.44 months, respectively. The median OS of the effective group and the ineffective group was 77.93 months and 16.37 months (P=0.017), and the median PFS of the effective group and the ineffective group was 9.86 months and 1.80 months, respectively (P=0.001). Univariate analysis and multivariate analysis showed that patients in the effective group had longer OS and PFS (P=0.006 and P=0.001, respectively). Patients with SUVmax ≤11.05 had longer PFS and OS, while patients with ΔSUVmax>8 and ΔSUVmax%>54.5% showed only longer PFS, and the difference in OS was not statistically significant.
      Conclusions  Interim PET-CT results and SUVmax can effectively predict the OS and PFS of relapsed DLBCL patients. ΔSUVmax and ΔSUVmax% can effectively predict the PFS of relapsed DLBCL patients.

     

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