摘要
目的 评价^(18)F-FDG PET/CT对不同Bcl-2、Bcl-6及MYC蛋白表达的弥漫大B细胞淋巴瘤(DLBCL)患者的预后评估价值。资料与方法 回顾性纳入2015年1月—2020年1月苏州大学附属第一医院164例初诊DLBCL患者,根据免疫组化结果将病例分为对照组97例、双表达组30例及三表达组37例,记录一般资料、Bcl-2、Bcl-6、MYC蛋白表达情况及患者化疗前后的^(18)F-FDG PET/CT表现,并对3组患者进行生存分析,研究最大标准化摄取值(SUVmax)、△SUVmax等对DLBCL患者预后的影响。结果 随访结束时,164例患者中死亡42例(25.61%),3组间总体生存率差异有统计学意义(χ^(2)=49.105,P<0.05);进展49例(29.87%),3组间无进展生存率差异有统计学意义(χ^(2)=78.224,P<0.05)。受试者工作特征曲线分析显示,化疗后SUVmax界值3.42,△SUVmax界值77.16%。SUVmax<3.42组和SUVmax≥3.42组无进展生存率及总体生存率差异有统计学意义(χ^(2)=68.659、19.201,P<0.05);△SUVmax<77.16%组和△SUVmax≥77.16%组的无进展生存期率和总体生存率差异有统计学意义(χ^(2)=50.025、17.611,P<0.05);化疗后SUVmax、△SUVmax、化疗后Deauville评分均对DLBCL患者具有独立预后价值。结论 双表达组及三表达组化疗效果较差,在随访周期内易复发或出现新病灶,预后较对照组差;^(18)F-FDG PET/CT可用于评估DLBCL淋巴瘤预后;化疗后SUVmax、△SUVmax、化疗后Deauville评分均可显著影响患者预后。
Purpose To evaluate the prognostic value of 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma(DLBCL)with different expression of B-cell lymphoma-2(Bcl-2),Bcl-6 and myelocytomatosis oncogene protein(MYC)protein.Materials and Methods A total of 164 newly diagnosed DLBCL patients in the First Affiliated Hospital of Soochow University from January 2015 to January 2020 were retrospectively included,according to the results of immunohistochemistry,the patients were divided into 3 groups:control group(97 cases),double expression group(30 cases)and triple expression group(37 cases),and their clinical data and the expression of Bcl-2,Bcl-6 and MYC protein were analyzed.The 18F-FDG PET/CT manifestations of DLBCL patients before and after chemotherapy were analyzed,and the survival analysis of all DLBCL patients in 3 groups was conducted to study the influence of standardized uptake value(SUVmax)and△SUVmax on the prognosis of DLBCL patients.Results By the end of follow-up,42 of 164 patients(25.61%)had died,and the difference in overall survival rate among the three groups was statistically significant(χ^(2)=49.105,P<0.05).Among 164 patients,49(29.87%)developed progression free survival(PFS),and there was significant difference in PFS rate among these three groups(χ^(2)=78.224,P<0.05).The receiver operating characteristic curve analysis showed that the cut-off value of SUVmax after chemotherapy was 3.42 and the cut-off value of△SUVmax was 77.16%,respectively.There were significant differences in PFS rate and overall survival rate between SUVmax<3.42 group and SUVmax≥3.42 group(χ^(2)=68.659,19.201,P<0.05).There was significant difference in PFS rate and overall survival rate between the△SUVmax<77.16%group and the△SUVmax≥77.16%group(χ^(2)=50.025,17.611,P<0.05).SUVmax,△SUVmax and Deauville score after chemotherapy were the independent prognostic values in DLBCL patients.Conclusion The chemotherapy effect of double-expression group and triple-expression group is poor,and the recurrence or new lesions may be easy to occur in the follow-up period,and the prognosis is worse than that of control group.The 18F-FDG PET/CT can be used to evaluate the prognosis of DLBCL lymphoma.SUVmax,△SUVmax and Deauville score after chemotherapy can significantly affect the prognosis of DLBCL patients.
作者
董佳佳
桑士标
DONG Jiajia;SANG Shibiao(Department of Nuclear Medicine,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第8期833-837,843,共6页
Chinese Journal of Medical Imaging
作者简介
通信作者:桑士标.ssbsdfyy@163.com。
