摘要
目的:观察18氟-氟代脱氧葡萄糖-正电子发射计算机体层显像(^(18)F-fluorodeoxyglucose-positron emission computed tomography,^(18)F-FDG PET/CT)在评估鼻型结外自然杀伤/T细胞淋巴瘤(extranodal natural killer/T-cell lymphoma,nasal type,ENKTL)治疗预后的价值。方法:回顾性分析2014年10月至2021年6月间在本院就诊并经病理证实的41例新诊断ENKTL患者。所有患者均接受氨甲蝶呤、依托泊苷、地塞米松和培门冬酶(methotrexate,etoposide,dexamethasone and pegaspargase,MESA)方案治疗,记录ENKTL患者治疗前、治疗中期、治疗结束后的^(18)F-FDG PET/CT显像结果,收集指标包括Deauville评分(Deauville score,DS)、最大标准化摄取值(maximal standardized uptake values,SUVmax)和SUVmax变化(ΔSUVmax)。采用单因素和多因素分析以评估这些指标对患者总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)的预测价值。结果:本研究中位随访期为45个月(3~64个月),患者2年的总生存率和无进展生存率分别为83.0%±6.0%和76.0%±7.0%,5年的指标分别为61.0%±12.0%和53.0%±10.0%。单因素分析显示,治疗前Ann Arbor分期(P=0.002),治疗中期DS(P=0.021)、SUVmax(P<0.001)、ΔSUVmax(P=0.007),和治疗结束后DS(P=0.001)、SUVmax(P=0.017)和ΔSUVmax(P=0.037)是治疗后总生存率的预后因素。治疗前Ann Arbor分期(P=0.006)、治疗中期DS(P=0.011)、SUVmax(P=0.015)、ΔSUVmax(P=0.011)和治疗结束后DS(P=0.018)是治疗后PFS的预后因素。多变量分析显示,治疗结束时的DS是无进展生存率的唯一独立预测因子(P=0.019),低DS与高DS的2年无进展生存率分别为90.3%±5.3%和50.0%±25.0%(P=0.018)。结论:ENKTL患者治疗结束时,^(18)F-FDG PET/CT显像的DS是唯一独立预后因素,高DS提示2年无进展生存率低。
Objective:To evaluate the prognostic significance of ^(18)F-fluorodeoxyglucose-positron emission computed tomography(^(18)F-FDG PET/CT)detection in extranodal natural killer/T-cell lymphoma,nasal type(ENKTL).Methods:Forty-one pathologically confirmed ENKTL patients(from October,2014 to June,2021)received methotrexate,etoposide,dexamethasone and pegaspargase(MESA)regimen and pre-,mid-,and end-treatment ^(18)F-FDG PET/CT scans were retrospectively analyzed.Deauville score(DS),maximal standardized uptake values(SUVmax)and the change of SUVmax(ΔSUVmax)were recorded for response assessment.Univariate and multivariate analysis were performed to assess the effects on overall survival(OS)and progression-free survival(PFS).Results:The median follow-up period was 45 months(range,3-64 months).The rates of 2-year OS and PFS were 83.0%±6.0%and 76.0%±7.0%,respectively.The rates of 5-year OS and PFS were 61.0%±12.0%and 53.0%±10.0%,respectively.Univariate analysis revealed that pre-treatment Ann Arbor stage(P=0.002),mid-treatment DS(P=0.021),mid-SUVmax(P<0.001),mid-ΔSUVmax(P=0.007),end-treatment DS(P=0.001),end-SUVmax(P=0.017)and end-ΔSUVmax(P=0.037)were prognostic factors for OS.Pre-treatment Ann Arbor stage(P=0.006),mid-treatment DS(P=0.011),SUVmax(P=0.015),SUVmax(P=0.011)and end-treatment DS(P=0.018)were of prognostic significance for PFS.Multivariate analysis showed that DS at the end of treatment was the only significant independent predictor of PFS(P=0.019).The rates of 2-year PFS of low DS and high DS were 90.3%±5.3%and 50.0%±25.0%,respectively(P=0.018).Conclusions:For ENKTL,DS by ^(18)F-fluoro at the end of treatment is the only significant independent predictor of PFS.
作者
王瑾
郭睿
李彪
张晓哲
WANG Jin;GUO Rui;LI Biao;ZHANG Xiaozhe(Department of Nuclear Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Collaborative Innovation Center for Molecular Imaging of Precision Medicine,Ruijin Center,Shanghai 200025,China)
出处
《诊断学理论与实践》
2022年第6期702-709,共8页
Journal of Diagnostics Concepts & Practice
基金
国家自然科学基金面上项目(82171975)
上海市临床重点专科建设项目(shslczdzk03403)
作者简介
通信作者:张晓哲,E-mail:zxz40909@rjh.com.cn
