Clinical Investigation
Predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for medium-term outcome in patients with primary gastrointestinal diffuse large B cell lymphoma
Zhang Zeyu, Cheng Chao, Wen Jiannan, Gu Zhenyong, Mao Juanli, Zhang Yingying, Liang Siyu, Wang Mingxin, Zuo Changjing
Published 2023-02-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(2): 85-90. DOI: 10.3760/cma.j.cn321828-20210916-00330
Abstract
ObjectiveTo explore the predictive value of 18F-FDG PET/CT metabolic parameters combined with inflammatory markers for the medium-term efficacy of chemotherapy in patients with primary gastrointestinal diffuse large B cell lymphoma (PGI-DLBCL).
MethodsFrom April 2011 to May 2020, 67 patients (37 males, 30 females, age: 28-85 years) with PGI-DLBCL examined by 18F-FDG PET/CT before chemotherapy in Changhai Hospital, Navy Medical University were retrospectively analyzed. All patients were treated with cyclophosphamide+ doxorubicin+ vincristine+ prednisone (CHOP) or rituximab+ CHOP (R-CHOP) regimens, and the medium-term efficacy was evaluated after 2-4 cycles of chemotherapy. The effect outcome was divided into complete remission (CR) group and non-CR (NCR) group based on the Lugano lymphoma response evaluation criteria. Mann-Whitney U test was used to compare the differences of SUVmax, peak of SUV (SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), platelet/lymphocyte ratio (PLR) and neutrophil/lymphocyte ratio (NLR) between two groups. The independent risk factors of NCR were analyzed by multivariate logistic regression and the binary logistic regression model was established according to the results. The model was tested with external validation data (n=15).
ResultsOf 67 PGI-DLBCL patients, 28(41.8%) were CR and 39(58.2%) were NCR. SUVpeak, MTV, TLG, PLR and NLR in NCR group (17.3(12.3, 28.1), 73.8(42.9, 141.7) cm3, 887.5(300.9, 2 075.3) g, 203.9(155.7, 297.1), 3.9(3.0, 4.9)) were significantly higher than those in CR group (9.5(6.2, 15.2), 11.3(4.7, 23.2) cm3, 85.2(35.5, 214.6) g, 149.3(102.8, 173.1), 2.2(1.8, 4.6); z values: from -6.41 to -2.33, all P<0.05). The logistic regression model was as follows: P=1/(1+ e-x), x=0.100×MTV+ 0.024×PLR-8.064. The prediction accuracy for NCR risk was 86.57%(58/67), with the accuracy of 13/15 tested by external validation data.
ConclusionMTV combined with PLR has a good predictive value for medium-term efficacy of CHOP/R-CHOP chemotherapy in patients with PGI-DLBCL.
Key words:
Lymphoma, large B-cell, diffuse; Gastrointestinal tract; Drug therapy; Positron-emission tomography; Tomography, X-ray computed; Fluorodeoxyglucose F18; Treatment outcome; Forecasting
Contributor Information
Zhang Zeyu
School of Medical Imaging, Xuzhou Medical University, Xuzhou 221000, China
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Cheng Chao
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Wen Jiannan
The First Outpatient Department, General Hospital of PLA Northern Theater Command, Shenyang 110001, China
Gu Zhenyong
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Mao Juanli
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Zhang Yingying
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Liang Siyu
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Wang Mingxin
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
Zuo Changjing
School of Medical Imaging, Xuzhou Medical University, Xuzhou 221000, China
Department of Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai 200433, China
