Evaluation of bone marrow involvement in extranodal NK/T cell lymphoma by FDG-PET/CT
Evaluation of bone marrow involvement in extranodal NK/T cell lymphoma by FDG-PET/CT
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DOI：
10.1007/s00277-014-2289-4
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发表时间：
2015-06-01
影响因子：
3.5
通讯作者：
Zhang, Mingzhi
中科院分区：
文献类型：
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作者：
Zhou, Zhiyuan;Chen, Changying;Zhang, Mingzhi
如果骨髓疾病是局灶性的，通过常规骨髓活检（BMB）评估骨髓受累（BMI）可能产生假阴性结果。18F-2-氟-2-脱氧-d-葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）评估结性NK/T细胞淋巴瘤（ENKL）BMI的敏感性尚未确定。我们回顾性收集了55例新诊断ENKL患者的临床数据，这些患者在治疗前接受了FDG-PET/CT和BMB。BMB结果用作参比标准品。12名患者（21.8%）被FDG-PET/CT（PET-CT/BM+）认为是阳性淋巴瘤浸润，5名患者（9%）被BMB（BMB/BM+）鉴定为阳性。7例PET-CT/BM+但BMB/BM-的患者结果不一致。FDG-PET/CT诊断BMI的敏感性和特异性分别为100%和86%。然后，我们分析了PET-CT/BM+和PET-CT/BM-患者的总生存期（OS）和无进展生存期（PFS）。中位随访时间为16个月（范围：3 - 43个月）。PET-CT/BM+组2年OS明显低于PET-CT/BM-组（84.8vs67.9%，P < 0.05）。PET-CT/BM-和PET-CT/BM+患者的估计2年PFS分别为72.7%和41.9%（P < 0.05）。然而，由于PET-CT/BM+患者数量较少，因此很难得出PET-CT/BM+患者的生存率与晚期患者相似的结论。总之，FDG-PET/CT可以补充检测ENKL中BMB遗漏的阳性BMI患者。FDG-PET/CT用于确定骨髓状态具有重要的预后价值。
Evaluation of bone marrow involvement (BMI) by conventional bone marrow biopsy (BMB) can generate false-negative results if marrow disease is focal. The sensitivity of 18F-2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) in assessing BMI in extranodal NK/T cell lymphoma (ENKL) has not been determined. We retrospectively collected clinical data from a series of 55 patients with newly diagnosed ENKL, who have received both FDG-PET/CT and BMB prior to treatment. BMB results were used as reference standard. Twelve patients (21.8 %) were considered positive lymphomatous infiltration by FDG-PET/CT (PET-CT/BM+), and five patients (9 %) were identified positive by BMB (BMB/BM+). There was a discordant result in seven patients who were PET-CT/BM+ but BMB/BM-. The sensitivity and specificity of FDG-PET/CT for identifying BMI were 100 and 86 %, respectively. Then, we analyzed the overall survival (OS) and progression-free survival (PFS) of patients who were PET-CT/BM+ and PET-CT/BM-. The median follow-up time was 16 months (range, 3 to 43 months). PET-CT/BM+ patients possessed worse 2-year OS than PET-CT/BM- patients (84.8 vs 67.9 %, P < 0.05). The estimated 2-year PFS for PET-CT/BM- and PET-CT/BM+ patients were 72.7 and 41.9 % (P < 0.05), respectively. However, it was hard to conclude that patients who were PET-CT/BM+ had similar survivals to advanced-stage patients due to the low number of patients who were PET-CT/BM+. In conclusion, FDG-PET/CT can complementally detect positive BMI patients missed by BMB in ENKL. The utility of FDG-PET/CT for defining bone marrow status has important prognostic value.