18F-FDG PET/CT基线SUVmax在滤泡性淋巴瘤侵袭性、分期评价中的价值及其与中期疗效的相关性研究

Evaluation of invasiveness, staging, and correlation with interim therapeutic response based on baseline 18F-FDG PET/CT SUVmax in patients with follicular lymphoma

    摘要
  • 摘要:
    目的探讨18F-FDG PET/CT基线最大标准化摄取值（SUVmax）在评估滤泡性淋巴瘤（FL）侵袭性、临床分期中的应用价值及其与R-CHOP（利妥昔单抗联合环磷酰胺、阿霉素、长春新碱和泼尼松）化疗方案中期疗效的相关性。
    方法回顾性研究R-CHOP方案化疗前行基线18F-FDG PET/CT检查的FL患者48例，其中18例患者在3个周期R-CHOP化疗后再次行18F-FDG PET/CT检查进行疗效评估。应用两个独立样本t检验和Mann-Whitney U检验评价低级别FL组（病理分级为1~2级、3a级）与高级别FL组（病理分级为3b级及以上）、局限期组与播散期组、完全缓解组与非完全缓解组患者的基线SUVmax差异；应用Spearman相关分析评价基线SUVmax与不同Ann Arbor分期的相关性。
    结果低级别FL组与高级别FL组患者的基线SUVmax差异有统计学意义（6.23±4.68 vs.13.20±6.68，t=3.919，P<0.001），受试者工作特征曲线（ROC）下面积为0.835。基线SUVmax与Ann Arbor分期无显著相关性（r=0.242，P=0.098）。低级别FL患者中局限期组的基线SUVmax明显低于播散期组，差异有统计学意义（中位数1.20 vs.7.85，U=24.000，P<0.001），ROC曲线下面积为0.905。R-CHOP中期化疗后疗效完全缓解组的基线SUVmax明显低于非完全缓解组，差异有统计学意义（5.16±3.05 vs.10.99±7.45，t=2.172，P=0.045）。
    结论18F-FDG PET/CT基线SUVmax可有效评估FL的侵袭性，并与R-CHOP方案的中期疗效、低级别FL患者的病变播散程度密切相关。

     

    Abstract:
    ObjectiveTo study the value of baseline 18F-FDG PET/CT maximum standardized uptake value (SUVmax) in evaluating the invasiveness, staging, and correlation between baseline SUVmax and the interim therapeutic response in patients with follicular lymphoma (FL).
    MethodsForty-eight FL patients who underwent baseline 18F-FDG PET/CT scan before chemotherapy, with the combination regimen of rituximab, cyclophosphamide, hydroxydaunomycin, oncovin and prednisolone (R-CHOP), were studied. Eighteen patients underwent 18F-FDG PET/CT scan again after 3 cycles of R-CHOP treatment to evaluate the interim therapeutic response. Two-sample t-test and Mann-Whitney U test were used to evaluate the differences in the baseline SUVmax between the following:low-grade group (pathological grades 1-2 and 3a) and high-grade group (pathological grade not lower than grade 3b); non-disseminated stage group and disseminated stage group; and complete response (CR) group and non-CR group. Spearman's rank correlation coefficient was used to estimate the relation between the baseline SUVmax and the Ann Arbor staging.
    ResultsThe baseline SUVmax was significantly different between the low-and high-grade groups (6.23±4.68 vs. 13.20±6.68, t=3.919, P<0.001), and the area under the receiver operating characteristic curve (AUC) was 0.835. No significant relation was found between the baseline SUVmax and the Ann Arbor staging (r=0.242, P=0.098). The baseline SUVmax of the non-disseminated stage group was significantly lower than that of the disseminated stage group among low-grade FL patients (median:1.20 vs. 7.85, U=24.000, P<0.001), and the AUC was 0.905. The baseline SUVmax of the CR group was significantly lower than that of the non-CR group after the interim R-CHOP therapy (5.16±3.05 vs. 10.99±7.45, t=2.172, P=0.045).
    ConclusionsThe baseline 18F-FDG PET/CT SUVmax is effective in evaluating invasiveness and staging and is related to the interim therapeutic response among FL patients. Moreover, the baseline SUVmax is related to the disease dissemination among low-grade FL patients.

     

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