18F-FDG PET/CT在弥漫性大B细胞淋巴瘤疗效评价中的临床价值

Clinical value of 18F-FDG PET/CT in evaluation of curative effect on diffuse large B cell lymphoma

    摘要
  • 摘要:
    目的 探讨18F-FDG PET/CT在弥漫性大B细胞淋巴瘤（DLBCL）化疗早期及化疗后疗效评价中的临床价值。
    方法 回顾性分析采用美罗华联合环磷酰胺+多柔比星+长春新碱+泼尼松方案或环磷酰胺+多柔比星+长春新碱+泼尼松方案化疗的34例DLBCL患者的PET/CT结果。所有患者分别在化疗前、化疗6疗程后行PET/CT，比较化疗前后病灶最大标准化摄取值（SUVmax）及病灶最大直径（Dmax）；其中12例患者于化疗前、第2疗程结束后、第4疗程结束后行PET/CT，比较3组间的SUVmax与Dmax。对在化疗6疗程后行PET/CT显像已达到完全缓解的8例和部分缓解的10例患者进行临床随访，观察1年无进展生存期（PFS）。
    结果 ①34例患者化疗前和6疗程化疗后，SUVmax之间和Dmax之间的差异均有统计学意义（t=3.58和2.96，P均 < 0.05）。② 12例患者在化疗前、第2疗程结束后、第4疗程结束后，SUVmax之间和Dmax之间的差异均有统计学意义（F=18.64和4.33，P均 < 0.05）；第2疗程结束后与化疗前相比，病灶Dmax未见显著变化（t=1.05，P > 0.05），SUVmax显著降低（t=5.37，P < 0.05）；第4疗程结束后与化疗前相比，SUVmax之间和Dmax之间的差异均具有统计学意义（t=8.56和3.90，P均 < 0.05）。③对18例患者进行的随访发现，完全缓解的8例中，PFS > 1年者6例，PFS < 1年者2例；部分缓解的10例中，PFS > 1年者2例，PFS < 1年者8例。
    结论 在DLBCL化疗早期及化疗后的疗效评价上，PET比CT更灵敏，以两种显像方法相结合的PET/CT在淋巴瘤疗效评价上具有较高的临床价值。

     

    Abstract:
    Objective To explore the clinical value of 18F-FDG PET/CT in evaluation of curative effect on diffuse large B-cell lymphoma(DLBCL).
    Methods 18F-FDG PET/CT was performed before and after 6 cycles of chemotherapy(R-CHOP or CHOP protocol) in 34 patients. By measuring maximum SUV(SUVmax) and maximum diameter(Dmax), the clinical value of PET and CT were compared in evaluation of curative effect on DLBCL after chemotherapy. Twelve patients underwent PET/CT examination for three times: before treatment, after 2 cycles of chemotherapy and after 4 cycles of chemotherapy. SUVmax and Dmax were compared among three groups. All the 8 patients who have reached complete response and 10 patients who have reached partial response after 6 cycles of chemotherapy were followed-up, and then the one-year progression-free survival (PFS) was observed.
    Results ①There was significant difference between SUVmax and Dmax before and after 6 cycles of chemotherapy on DLBCL patients(t=3.58 and 2.96, both P < 0.05). ② There was significant difference among before, after 2 cycles of chemotherapy, after 4 cycles of chemotherapy in SUVmax and Dmax (F= 18.64 and F=4.33, both P < 0.05). There was significant difference of SUVmax between before and after 2 cycles of chemotherapy (t=5.37, P < 0.05), and no difference of Dmax(t=1.05, P > 0.05). There was significant difference of both SUVmax and Dmax between before and 4 cycles of chemotherapy(t=8.56 and 3.90, both P < 0.05). ③Among 8 patients who have reached complete response, 6 cases were PFS > 1, 2 cases were PFS < 1. Among 10 patients who have reached partial response, 2 cases were PFS > 1, 8 cases were PFS < 1.
    Conclusions In evaluation curative effect on malignant DLBCL during and after treatment, PET was significantly better than CT. PET/CT as combination of PET with CT had a higher clinical value to evaluate the therapeutic effect of DLBCL.

     

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