汤泊; 周东亚; 刘敏; 丁重阳

doi:10.3760/cma.j.cn321828-20210302-00050

点赞 0
分享 0
收藏 0
纠错

• 淋巴瘤指南解读与应用 •

治疗前¹⁸F-FDG PET/CT显像代谢参数对老年经典型霍奇金淋巴瘤的预后价值

中华核医学与分子影像杂志, 2022,42(4) : 196-201. DOI: 10.3760/cma.j.cn321828-20210302-00050

摘要

目的

研究治疗前¹⁸F-FDG PET/CT显像的代谢参数对老年经典型霍奇金淋巴瘤(cHL)的预后价值。

方法

回顾性分析2011年4月至2020年4月间于南京医科大学第一附属医院经病理确诊的42例老年cHL患者(男29例、女13例，中位年龄69岁)治疗前的临床及PET/CT显像资料。以41%SUV_max为阈值获得病灶的肿瘤代谢体积(MTV)和病灶糖酵解总量(TLG)。利用ROC曲线分析获得SUV_max、MTV、TLG的预后最佳阈值。采用Kaplan-Meier法和log-rank检验进行单因素生存分析，采用Cox比例风险回归模型进行多因素分析。

结果

42例老年cHL患者的SUV_max、MTV、TLG分别为16.49(12.24，23.59)、79.29(26.29，184.51) ml、729.02(206.03，2 073.98) g。ROC曲线分析示SUV_max、MTV、TLG的AUC分别为0.425、0.882、0.832；判断预后的最佳阈值分别为16.49、82.38 ml、556.26 g。单因素分析示年龄、B症状、乳酸脱氢酶(LDH)、Hb含量、Ann Arbor分期、德国霍奇金淋巴瘤研究组(GHSG)评分、MTV、TLG是患者无进展生存(PFS)率的影响因素(χ²值：4.50~12.60，均P<0.05)；年龄、B症状、LDH、Ann Arbor分期、GHSG评分、MTV、TLG是患者总生存(OS)率的影响因素(χ²值：5.20~11.17，均P<0.05)。多因素分析示MTV、TLG是影响患者PFS率的独立危险因素[相对危险度(RR): 5.370(95% CI: 1.697~16.277)、4.854(95% CI: 1.228~23.352)，均P<0.05]；GHSG评分、MTV、TLG是影响患者OS率的独立危险因素[RR: 3.761(95% CI: 1.092~12.955)和3.668(95% CI：1.068~12.571)、6.173(95% CI: 1.431~16.322)、5.162(95% CI: 1.200~22.199)，均P<0.05]。

结论

治疗前¹⁸F-FDG PET/CT显像中MTV和TLG是影响老年cHL患者PFS和OS的独立危险因素，对老年cHL患者的预后判断具有一定的参考价值。

引用本文: 汤泊, 周东亚, 刘敏, 等. 治疗前¹⁸F-FDG PET/CT显像代谢参数对老年经典型霍奇金淋巴瘤的预后价值 [J] . 中华核医学与分子影像杂志, 2022, 42(4) : 196-201. DOI: 10.3760/cma.j.cn321828-20210302-00050.

参考文献导出: Endnote NoteExpress RefWorks NoteFirst 医学文献王

扫描看全文

正文

作者信息

基金 0 关键词 0

English Abstract

阅读 0 评论 0

相关资源

引用 | 论文 | 视频

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

老年霍奇金淋巴瘤(Hodgkin′s lymphoma, HL)发病率较低，约占初诊HL的15%^[1]，以经典型HL(classical HL, cHL)为主。我国HL发病率低于欧美国家，老年cHL患者在我国少见。相对于青年cHL，老年cHL患者由于体质较弱，且常合并其他并发症，缺乏根治性治疗方案，预后较差，5年生存率为40%~70%^[2]。¹⁸F-FDG PET/CT在cHL分期、疗效判断及预后评价中具有重要价值，其在cHL中的应用已被我国相关指南推荐采用^[3]，但在判断老年cHL预后方面的文献报道少见。因此，本研究回顾性分析了42例老年cHL患者¹⁸F-FDG PET/CT显像资料和临床资料，旨在探讨治疗前¹⁸F-FDG PET/CT显像测得的病灶SUV_max、肿瘤代谢体积(metabolic tumor volume, MTV)及病灶糖酵解总量(total lesion glycolysis, TLG)对老年cHL患者的预后价值。

贡献者信息

汤泊

南京中医药大学沭阳附属医院影像科，宿迁　223600

周东亚

南京中医药大学沭阳附属医院影像科，宿迁　223600

刘敏

南京中医药大学沭阳附属医院影像科，宿迁　223600

丁重阳

南京医科大学第一附属医院核医学科，南京　210029

通信作者

丁重阳

南京医科大学第一附属医院核医学科，南京　210029

Email：chongyangding@163.com

关键词

霍奇金病; 正电子发射断层显像术; 体层摄影术，X线计算机; 氟脱氧葡萄糖F18; 预后;

作者声明

作者贡献声明

汤泊：研究实施、论文撰写；周东亚、刘敏：统计分析；丁重阳：研究指导、论文修改

利益冲突

所有作者声明无利益冲突

历史

出版日期：2022-04-25

收稿日期：2021-03-02

Interpretation and Application of Guideline of Lymphoma

Prognostic value of pretreatment ¹⁸F-FDG PET/CT metabolic parameters in elderly classical Hodgkin′s lymphoma

Tang Bo, Zhou Dongya, Liu Min, Ding Chongyang

Published 2022-04-25

Cite as Chin J Nucl Med Mol Imaging, 2022, 42(4): 196-201. DOI: 10.3760/cma.j.cn321828-20210302-00050

Abstract

Objective

To investigate the prognostic value of pretreatment ¹⁸F-FDG PET/CT metabolic parameters in patients with elderly classical Hodgkin′s lymphoma (cHL).

Methods

From April 2011 to April 2020, the pretreatment clinical and ¹⁸F-FDG PET/CT metabolic parameters of 42 elderly cHL patients (29 males and 13 females, median age 69 years) pathologically confirmed in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained with 41%SUV_max as the threshold. ROC curve analysis was applied to obtain the best prognostic cut-off value of SUV_max, MTV and TLG. Kaplan-Meier method and log-rank test were used for univariate survival analysis, and Cox proportional hazard regression model was used for multivariate survival analysis.

Results

SUV_max, MTV and TLG of 42 elderly cHL patients were 16.49(12.24, 23.59), 79.29(26.29, 184.51) ml and 729.02(206.03, 2 073.98) g, respectively. ROC curve showed that the AUCs of SUV_max, MTV and TLG were 0.425, 0.882 and 0.832, respectively, and the best prognostic cut-off values were 16.49, 82.38 ml and 556.26 g, respectively. Univariate analysis showed that age, B symptoms, lactate dehydrogenase (LDH) level, Hb content, Ann Arbor stage, German Hodgkin Study Group (GHSG) score, MTV and TLG were relative factors affecting progression-free survival (PFS) rate (χ² values: 4.50-12.60, all P<0.05), and age, B symptoms, LDH level, Ann Arbor stage, GHSG score, MTV and TLG were relative factors affecting overall survival (OS) rate (χ² values: 5.20-11.17, all P<0.05). Multivariate analysis showed that MTV (relative risk (RR)=5.370, 95% CI: 1.697-16.277) and TLG (RR=4.854, 95% CI: 1.228-23.352) were independent prognostic predictors of PFS rate (both P<0.05), and GHSG score (RR=3.761, 95% CI: 1.092-12.955; RR=3.668, 95% CI: 1.068-12.571), MTV (RR=6.173, 95% CI: 1.431-16.322) and TLG (RR=5.162, 95% CI: 1.200-22.199) were independent prognostic predictors of OS rate (all P<0.05).

Conclusion

MTV and TLG in pretreatment ¹⁸F-FDG PET/CT are independent prognostic factors for predicting PFS and OS in patients with elderly cHL patients, which have certainly reference value for prognosis.

Key words:

Hodgkin disease; Positron-emission tomography; Tomography, X-ray computed; Fluorodeoxyglucose F18; Prognosis

Contributor Information

Tang Bo

Department of Radiology, ShuYang Affiliated Hospital of Nanjing University of Chinese Medicine, Suqian 223600, China

Zhou Dongya

Department of Radiology, ShuYang Affiliated Hospital of Nanjing University of Chinese Medicine, Suqian 223600, China

Liu Min

Department of Radiology, ShuYang Affiliated Hospital of Nanjing University of Chinese Medicine, Suqian 223600, China

Ding Chongyang

Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

共有条评论

验证码

本文被引情况 CSCD: 0次万方数据： 0次 Scopus: 0次

施引文献(最多仅列5条文献，进入CSCD官网发现更多)

未获取施引文献信息...

暂无相关资源