Prognostic Value of Bone Marrow FDG Uptake Pattern of PET/CT in Newly Diagnosed Diffuse Large B-cell Lymphoma.
Prognostic Value of Bone Marrow FDG Uptake Pattern of PET/CT in Newly Diagnosed Diffuse Large B-cell Lymphoma.
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PET/CT 骨髓 FDG 摄取模式对新诊断弥漫性大 B 细胞淋巴瘤的预后价值
DOI：
10.7150/jca.23714
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发表时间：
2018
影响因子：
3.9
通讯作者：
Huang G
中科院分区：
文献类型：
--
作者：
Chen Y;Zhou M;Liu J;Huang G
目的：18F-FDG PET/CT在评估淋巴瘤骨髓受累（BMI）中的价值仍存在争议。本研究旨在评价PET/CT显像中骨髓FDG摄取模式对新诊断弥漫性大B细胞淋巴瘤（DLBCL）患者预后的意义。材料与方法：回顾性分析193例初治DLBCL患者的临床资料。所有患者均接受利妥昔单抗+环磷酰胺、阿霉素、长春新碱和泼尼松（R-CHOP）治疗6-8个周期。由两名盲法评价者独立记录BM FDG摄取模式的类型。分析其临床病理特征与BM分型的关系。采用Log-rank检验和Cox回归分析评价不同BM模式的预后价值。结果如下：在193例患者中，28例（15%）患者的局灶性BM FDG摄取高于肝脏（fPET+），18例（9%）患者的弥漫性BM摄取高于肝脏（dPET+），147例（76%）患者的BM摄取正常（低于肝脏）（nPET）。fPET+组BMB阳性率为35.7%（10/28），dPET+组为16.7%（3/18），nPET组为0.7%（1/147）。弥漫性骨髓模式与较低的血红蛋白水平和较高的红细胞沉降率（ESR）的趋势。与nPET患者相比，dPET+患者的3年无进展生存期（3年PFS）和3年总生存期（3年OS）相似（80.5%对81.5%，p=0.701; 94.1% vs 90.6%，p=0.809），而fPET+患者的3年PFS和3年OS比fPET-患者差（分别为32.7% vs 81.4%，p<0.001; 69.4% vs 90.9%，p=0.003）。多因素分析显示fPET+（HR=2.270，p=0.025）和III/IV期（HR=4.909，p=0.026）是PFS的独立预测因素，但没有因素是OS的独立预测因素。结论：PET/CT引导的BM模式对新诊断DLBCL患者的预后有意义。局灶性BM模式是PFS的独立预测因素。
Purpose: The value of 18F-fluorodeoxyglucose positron emission tomography /computed tomography (18F-FDG PET/CT) in assessing bone marrow involvement (BMI) of lymphoma remains controversial. The present study aims to evaluate the prognostic meaning of bone marrow FDG uptake pattern in PET/CT of newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients. Materials and Methods: 193 newly diagnosed DLBCL patients were retrospectively analyzed. All patients received 6-8 cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP). The type of BM FDG uptake pattern was recorded by two blinded reviewers independently. The relationship between clinicopathologic features and BM patterns was analyzed. The prognostic value of different BM patterns was evaluated by Log-rank test and Cox-regression analysis. Results: Out of 193 patients, 28 (15%) patients had focal BM FDG uptake higher than liver (fPET+), 18 (9%) patients showed diffuse BM uptake higher than liver (dPET+) and 147 (76%) patients had normal BM uptake (lower than liver) (nPET). BMB positive was found in 35.7% (10/28) of fPET+ patients, in 16.7% (3/18) of dPET+ patients and in 0.7% (1/147) of nPET patients. Diffuse BM pattern was associated with lower hemoglobin level and a trend of higher erythrocyte sedimentation rate (ESR). dPET+ patients had similar 3y-progression-free survival (3y-PFS) and 3y-overall survival (3y-OS) compared with nPET patients (80.5% vs 81.5%, p=0.701; 94.1% vs 90.6%, p=0.809, respectively), while fPET+ patients had worse 3y-PFS and 3y-OS compared with fPET- patients (32.7% vs 81.4%, p<0.001; 69.4% vs 90.9%, p=0.003, respectively). Multivariate analysis showed fPET+ (HR=2.270, p=0.025) and stage III/IV (HR=4.909, p=0.026) were independent predictors for PFS, but no factors were independently predictive for OS. Conclusion: PET/CT-directed BM patterns are meaningful in predicting prognosis of newly diagnosed DLBCL patients. Focal BM pattern is an independent predictor for PFS.
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影响因子：
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作者：
Liang JH;Sun J;Wang L;Fan L;Chen YY;Qu XY;Li TN;Li JY;Xu W
通讯作者：
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影响因子：
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作者：
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作者：
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通讯作者：
Grp, E. S. M. O. Guidelines Working
影响因子：
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作者：
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通讯作者：
Carr, Robert
DOI：
10.3816/clm.2004.n.012
发表时间：
2004-06-01
期刊：
CLINICAL LYMPHOMA
影响因子：
--
作者：
Elstrom, RL;Tsai, DE;Schuster, SJ
通讯作者：
Schuster, SJ