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弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)是非霍奇金淋巴瘤最常见的类型之一,近年来,利妥昔单抗的使用在一定程度上改善了患者的预后。但是,由于DLBCL具有较高的异质性,部分患者预后较差,目前仍有30%~40%的患者在治疗过程中出现疾病进展或复发[1]。18F-FDG PET/CT 具有分子影像和解剖结构显像的双重优势,广泛应用于淋巴瘤的诊断、分期、疗效监测和预后评估。已有不少研究结果证实,PET/CT Deauville评分对化疗中期DLBCL患者的生存有预测价值[2-4]。 PET/CT代谢参数中, SUVmax、全身所有病灶总的代谢肿瘤体积(total metabolic tumor volume, TMTV)、总的糖酵解总量(total of total lesion glycolysis, TTLG)对DLBCL患者预后的预测价值一直是研究的热点,但是,对于化疗中期的评估结果仍存在争议[5]。本研究通过分析18F-FDG PET/CT 参数及临床相关因素与化疗中期DLBCL患者无进展生存(progress-free survival, PFS)期和总生存(overall survival, OS)期的关系,探讨临床因素和18F-FDG PET/CT代谢参数及解剖测量参数对DLBCL患者预后判断的价值。
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112例DLBCL患者中,Ⅰ期和Ⅱ期50例,Ⅲ期和Ⅳ期62例;乳酸脱氧酶(lactate dehydrogenase,LDH)水平升高者55例,LDH水平正常者57例。其他临床特征见表1。患者无失访,中位随访时间为36(6~93)个月。112例DLBCL患者中,25例(22.3%)出现疾病进展、14例(12.5%)死亡。
临床因素 例数 死亡数 疾病进展数 Kaplan-Meier分析 中位PFS期(个月) χ2值 P值 中位OS期(个月) χ2值 P值 年龄 5.152 0.023 4.735 0.030 ≥60岁 39 8 13 25.0 29.0 <60岁 73 6 12 29.0 35.0 LDH水平 2.223 0.136 4.154 0.042 升高 55 10 15 27.0 29.0 正常 57 4 10 31.0 32.0 ECOG评分 17.810 <0.001 11.414 0.001 ≥2 32 9 15 27.5 30.5 <2 80 5 10 29.0 31.5 分期 6.136 0.105 6.824 0.078 Ⅰ 19 1 3 29.0 31.0 Ⅱ 31 1 3 32.0 33.0 Ⅲ 19 2 5 29.0 30.0 Ⅳ 43 10 14 25.0 26.0 IPI评分 13.298 0.004 17.473 0.001 低危 47 2 5 29.0 31.0 低中危 19 0 3 40.0 43.0 高中危 29 6 9 22.0 25.0 高危 17 6 8 24.0 33.0 NCCN-IPI评分 22.998 <0.001 19.687 <0.001 低危 27 1 3 29.0 29.0 低中危 48 2 6 32.5 35.0 高中危 30 8 11 23.0 24.0 高危 7 3 5 15.0 24.0 化疗方案 2.312 0.774 1.753 0.839 R-CDOP 40 6 11 21.0 26.5 R-CHOP 29 3 5 36.0 36.0 R-EPOCH 22 1 2 28.5 28.5 其他 21 4 7 35.0 41.0 注:DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;OS为总生存;LDH为乳酸脱氢酶;ECOG为美国东部肿瘤协作组; IPI 为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数;R-CDOP为利妥昔单抗+环磷酰胺+脂质体阿霉素+长春新碱+强的松;R-CHOP为利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松;R-EPOCH为利妥昔单抗+依托泊苷+强的松+长春新碱+环磷酰胺+表柔霉素 表 1 112例化疗中期DLBCL患者PFS期和OS期的临床特征分析
Table 1. Analysis of clinical characteristics of progress-free survival and overall survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
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由表2可知,18F-FDG PET/CT参数SUVmax、TMTV、TTLG、SPD预测DLBCL患者PFS期的最佳界值分别为1.75、6.40 cm3、9.30 g和3.53 cm2,AUC分别为0.712、0.652、0.680、0.728(95%CI:0.596~0.829、0.518~0.787、0.549~0.811、0.619~0.837,均P<0.05)。由表3可知,18F-FDG PET/CT参数SUVmax、TMTV、TTLG、SPD预测OS期的最佳临界值分别为3.75、17.80 cm3、19.05 g和5.67 cm2,AUC分别为0.727、0.686、0.727、0.757(95%CI:0.578~0.877、0.512~0.861、0.559~0.896、0.622~0.891,均P<0.05)。
参数 临界值 灵敏度(%) 特异度(%) AUC(95%CI) P值 SUVmax 1.75 68.0 63.2 0.712(0.596~0.829) 0.001 TMTV(cm3) 6.40 64.0 71.3 0.652(0.518~0.787) 0.021 TTLG(g) 9.30 64.0 73.6 0.680(0.549~0.811) 0.006 SPD(cm2) 3.53 64.0 75.9 0.728(0.619~0.837) 0.001 注:FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;AUC为曲线下面积;CI为置信区间;SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 2 18F-FDG PET/CT参数预测112例化疗中期DLBCL患者PFS期的临界值
Table 2. Cut-off values of 18F-FDG PET/CT parameters for predicting progress-free survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
参数 临界值 灵敏度(%) 特异度 (%) AUC(95%CI) P值 SUVmax 3.75 50.0 87.8 0.727(0.578~0.877) 0.006 TMTV(cm3) 17.80 57.1 86.7 0.686(0.512~0.861) 0.025 TTLG(g) 19.05 71.4 81.6 0.727(0.559~0.896) 0.006 SPD(cm2) 5.67 71.4 80.6 0.757(0.622~0.891) 0.002 注: FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;DLBCL为弥漫性大B细胞淋巴瘤;OS为总生存;AUC为曲线下面积;CI为置信区间;SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 3 18F-FDG PET/CT参数预测112例化疗中期DLBCL患者OS期的临界值
Table 3. Cut-off values of 18F-FDG PET/CT parameters for predicting overall survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
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Deauville评分结果显示,112例DLBCL患者中,4~5分阳性组32例,1~3分阴性组80例(其中1分63例、2分7例、3分10例),评分X的患者0例。如图1所示,以PFS期为研究终点,阳性组患者的PFS期与阴性组患者PFS期比较,差异有统计学意义(P<0.001);以OS期为研究终点,2组OS期的差异有统计学意义(P=0.009)。
图 1 18F-FDG PET/CT Deauville评分对112例化疗中期DLBCL患者PFS期和OS期预后分析的Kaplan-Meier生存曲线
Figure 1. Kaplan-Meier survival curves of prognosis of progress-free survival (A) and overall survival (B) in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy using Deauville criteria for 18F-FDG PET/CT
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单因素分析结果显示,年龄、美国东部肿瘤协作组(Eastern Cooperative Oncology Group, ECOG)评分、国际预后指数(International Prognostic Index,IPI)评分、美国国家综合癌症网络-国际预后指数(NCCN-IPI)评分是DLBCL患者PFS期和OS期的预后影响因素(均P<0.05);LDH水平是OS期的预后影响因素(P=0.042),但不是PFS期的预后影响因素(P=0.136) (表1)。
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将18F-FDG PET/CT代谢参数SUVmax、TMTV、TTLG和解剖测量参数SPD纳入单因素生存分析,结果显示,4个参数均是DLBCL患者PFS期和OS期的预后影响因素(均 P<0.01,图2)。
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将单因素分析中对DLBCL患者预后有统计学意义的临床因素和化疗中期 18F-FDG PET/CT参数进行多因素分析,结果显示:年龄、ECOG评分、TTLG是影响DLBCL患者PFS期的独立危险因素(均P<0.01,表4) ;SPD、LDH水平是影响DLBCL患者OS期的独立危险因素(均P<0.05,表5)。
因素 β值 Wald值 HR值 95%CI P值 年龄 −1.107 6.952 0.331 0.145~0.753 0.008 ECOG评分 −1.339 9.827 0.262 0.113~0.605 0.002 Deauville评分 −0.537 0.980 0.585 0.202~1.693 0.322 IPI评分 −0.418 0.147 0.658 0.078~5.566 0.701 NCCN-IPI评分 −0.183 0.074 1.200 0.321~4.489 0.786 SUVmax −0.342 0.280 0.711 0.201~2.517 0.596 TMTV −0.462 0.104 0.630 0.038~10.482 0.747 TTLG −1.269 8.320 0.281 0.119~0.666 0.004 SPD 0.062 0.007 1.064 0.256~4.422 0.932 注:DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;CI 为置信区间;ECOG为美国东部肿瘤协作组;IPI为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数; SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 4 影响112例化疗中期DLBCL患者PFS期的多因素分析
Table 4. Multivariate analysis of progression-free survival of 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
因素 β值 Wald值 HR值 95%CI P值 年龄 −0.237 0.795 0.789 0.469~1.328 0.372 ECOG评分 −0.364 1.580 0.695 0.394~1.226 0.209 Deauville评分 −0.312 0.918 0.732 0.387~1.385 0.338 IPI评分 −0.033 0.007 0.967 0.437~2.138 0.094 NCCN-IPI评分 −0.015 0.001 0.985 0.310~3.129 0.980 SUVmax 0.427 1.565 1.532 0.785~2.990 0.211 TMTV −0.748 1.386 0.437 0.136~1.644 0.239 TTLG 0.502 1.336 1.652 0.705~3.872 0.248 SPD 0.654 5.686 1.992 1.123~3.290 0.017 LDH水平 −0.521 4.174 0.594 0.360~0.979 0.041 注:DLBCL为弥漫性大B细胞淋巴瘤;OS为总生存;CI为置信区间;ECOG为美国东部肿瘤协作组;IPI为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数; SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和;LDH为乳酸脱氢酶 表 5 影响112例化疗中期DLBCL患者OS期的多因素分析
Table 5. Multivariate analysis of overall survival of 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
18F-FDG PET/CT对化疗中期弥漫性大B细胞淋巴瘤患者预后判断的价值
The value of 18F-FDG PET/CT in predicting the prognosis of patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
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摘要:
目的 探讨18F-氟脱氧葡萄糖(FDG)PET/CT参数对化疗中期弥漫性大B细胞淋巴瘤(DLBCL)患者预后判断的价值。 方法 回顾性分析2011年1月至2020年1月河北医科大学第四医院112例DLBCL患者的临床资料和化疗3~4周期后(中期)18F-FDG PET/CT显像资料,其中男性60例、女性52例,年龄16~79(49.5±16.6)岁。以最大标准化摄取值(SUVmax)的40%为阈值勾画感兴趣区(ROI),获得病灶的SUVmax、全身所有病灶总的代谢肿瘤体积(TMTV)、总的糖酵解总量(TTLG),在CT图像上测量6个靶病灶的最大垂直径乘积之和(SPD)。采用受试者工作特性(ROC)曲线计算各代谢参数和解剖测量参数预测患者无进展生存(PFS)期和总生存(OS)期的最佳临界值。采用Kaplan-Meier法进行生存分析,采用Log-rank检验进行单因素分析,采用Cox比例风险回归模型对单因素分析有统计学意义的预后影响因素进行多因素分析。 结果 112例DLBCL患者中,在随访期间25例(22.3%)出现疾病进展、14例(12.5%)死亡。18F-FDG PET/CT 参数SUVmax、TMTV、TTLG和SPD预测DLBCL患者PFS期的最佳临界值分别为1.75、6.40 cm3、9.30 g和3.53 cm2,曲线下面积(AUC)分别为0.712、0.652、0.680、0.728(95%CI:0.596~0.829、0.518~0.787、0.549~0.811、0.619~0.837,均P<0.05);预测OS期的最佳临界值分别为3.75、17.80 cm3、19.05 g和5.67 cm2,AUC分别为0.727、0.686、0.727、0.757(95%CI:0.578~0.877、0.512~0.861、0.559~0.896、0.622~0.891,均P<0.05)。单因素分析结果显示,年龄、美国东部肿瘤协作组(ECOG)评分、国际预后指数评分、美国国家综合癌症网络-国际预后指数评分、Deauville评分以及SUVmax、TMTV、TTLG、SPD均是DLBCL患者PFS期(χ2=5.152~22.998,均P<0.05)和OS期的影响因素(χ2=4.735~19.687,均P<0.05);乳酸脱氢酶(LDH)水平是OS期的影响因素(χ2=4.154,P<0.05),但不是PFS期的影响因素(χ2=2.223,P>0.05)。多因素分析结果显示,年龄、ECOG评分、TTLG是影响DLBCL患者PFS期的独立危险因素(HR=0.331、0.262、0.281,95%CI:0.145~0.753、0.113~0.605、0.119~0.666,均P<0.01);LDH水平、SPD是影响DLBCL患者OS期的独立危险因素(HR=0.594、1.922,95%CI:0.360~0.979、1.123~3.290,均P<0.05)。 结论 18F-FDG PET/CT参数 SUVmax、TMTV、TTLG、SPD对化疗中期DLBCL患者预后有较好的判断价值。 -
关键词:
- 淋巴瘤,大B细胞,弥漫性 /
- 正电子发射断层显像术 /
- 体层摄影术,X线计算机 /
- 氟脱氧葡萄糖F18 /
- 药物疗法 /
- 预后
Abstract:Objective To investigate the prognostic value of 18F-fluorodeoxyglucose (FDG) PET/CT parameters in patients with diffuse large B-cell lymphoma (DLBCL) in their middle stage of chemotherapy. Methods Clinical data and PET/CT imaging data of 112 DLBCL patients in the Fourth Hospital of Hebei Medical University from January 2011 to January 2020 after 3–4 cycles of chemotherapy were retrospectively analyzed, patients included 60 males and 52 females aged 16–79 (49.5±16.6) years. Then, 40% of the maximum standardized uptake value (SUVmax) was taken as the threshold to outline the region of interest (ROI) and subsequently obtain the SUVmax of lesion, total metabolic tumor volume (TMTV), and total of total lesion glycolysis (TTLG) of all lesions in the body. The sum of products of greatest diameter (SPD) of six target lesions were measured on a CT image. The optimal cut-off values of predicting the progress-free survival (PFS) and overall survival (OS) of the metabolic parameters and anatomical measurement parameters were calculated using the receiver operating characteristic (ROC) curve. The Log-rank test was used for univariate analysis. Kaplan-Meier method was used for the survival analysis. Cox proportional hazards regression model was used for the multivariate analysis of statistically significant prognostic factors obtained from the univariate analysis. Results Among 112 patients, 25 (22.3%) disease developed DLBCL and 14 (12.5%) died from DLBCL during the follow-up period. The optimal cut-off values of the 18F-FDG PET/CT parameters for SUVmax, TMTV, TTLG, and SPD for predicting the PFS of patients with DLBCL were 1.75, 6.40 cm3, 9.30 g, and 3.53 cm2, respectively, with corresponding area under curve (AUC) of 0.712, 0.652, 0.680 and 0.728 (95% CI: 0.596–0.829, 0.518–0.787, 0.549–0.811 and 0.619–0.837; all P<0.05). Meanwhile, the optimal cut-off values for predicting OS were 3.75, 17.80 cm3, 19.05 g, and 5.67 cm2, respectively, with corresponding AUC of 0.727, 0.686, 0.727 and 0.757 (95% CI: 0.578–0.877, 0.512–0.861, 0.559–0.896 and 0.622–0.891; all P<0.05). The results of univariate analysis indicate that age, Eastern Cooperative Oncology Group (ECOG) score, International Prognostic Index (IPI) score, National Comprehensive Cancer Network-IPI score, Deauville score, SUVmax, TMTV, TTLG, and SPD were the influencing factors of PFS (χ2=5.152–22.998, all P<0.05) and OS (χ2=4.735–19.687, all P<0.05). Meanwhile, lactate dehydrogenase (LDH) level only influences OS (χ2=4.154, P<0.05) but not PFS (χ2=2.223, P>0.05). Then, the results of multivariate analysis indicate that age, ECOG score, and TTLG were the independent risk factors affecting the PFS of patients with DLBCL (HR=0.331, 0.262, and 0.281; 95% CI: 0.145–0.753, 0.113–0.605 and 0.119–0.666; all P<0.01), whereas LDH level and SPD were the independent risk factors affecting the OS patients with DLBCL (HR=0.594, 1.922; 95% CI: 0.360–0.979 and 1.123–3.290; all P<0.05). Conclusions The 18F-FDG PET/CT parameters of SUVmax, TMTV, TTLG, and SPD have a good prognostic value for DLBCL patients in their middle stage of chemotherapy. -
图 1 18F-FDG PET/CT Deauville评分对112例化疗中期DLBCL患者PFS期和OS期预后分析的Kaplan-Meier生存曲线
Figure 1. Kaplan-Meier survival curves of prognosis of progress-free survival (A) and overall survival (B) in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy using Deauville criteria for 18F-FDG PET/CT
表 1 112例化疗中期DLBCL患者PFS期和OS期的临床特征分析
Table 1. Analysis of clinical characteristics of progress-free survival and overall survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
临床因素 例数 死亡数 疾病进展数 Kaplan-Meier分析 中位PFS期(个月) χ2值 P值 中位OS期(个月) χ2值 P值 年龄 5.152 0.023 4.735 0.030 ≥60岁 39 8 13 25.0 29.0 <60岁 73 6 12 29.0 35.0 LDH水平 2.223 0.136 4.154 0.042 升高 55 10 15 27.0 29.0 正常 57 4 10 31.0 32.0 ECOG评分 17.810 <0.001 11.414 0.001 ≥2 32 9 15 27.5 30.5 <2 80 5 10 29.0 31.5 分期 6.136 0.105 6.824 0.078 Ⅰ 19 1 3 29.0 31.0 Ⅱ 31 1 3 32.0 33.0 Ⅲ 19 2 5 29.0 30.0 Ⅳ 43 10 14 25.0 26.0 IPI评分 13.298 0.004 17.473 0.001 低危 47 2 5 29.0 31.0 低中危 19 0 3 40.0 43.0 高中危 29 6 9 22.0 25.0 高危 17 6 8 24.0 33.0 NCCN-IPI评分 22.998 <0.001 19.687 <0.001 低危 27 1 3 29.0 29.0 低中危 48 2 6 32.5 35.0 高中危 30 8 11 23.0 24.0 高危 7 3 5 15.0 24.0 化疗方案 2.312 0.774 1.753 0.839 R-CDOP 40 6 11 21.0 26.5 R-CHOP 29 3 5 36.0 36.0 R-EPOCH 22 1 2 28.5 28.5 其他 21 4 7 35.0 41.0 注:DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;OS为总生存;LDH为乳酸脱氢酶;ECOG为美国东部肿瘤协作组; IPI 为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数;R-CDOP为利妥昔单抗+环磷酰胺+脂质体阿霉素+长春新碱+强的松;R-CHOP为利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松;R-EPOCH为利妥昔单抗+依托泊苷+强的松+长春新碱+环磷酰胺+表柔霉素 表 2 18F-FDG PET/CT参数预测112例化疗中期DLBCL患者PFS期的临界值
Table 2. Cut-off values of 18F-FDG PET/CT parameters for predicting progress-free survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
参数 临界值 灵敏度(%) 特异度(%) AUC(95%CI) P值 SUVmax 1.75 68.0 63.2 0.712(0.596~0.829) 0.001 TMTV(cm3) 6.40 64.0 71.3 0.652(0.518~0.787) 0.021 TTLG(g) 9.30 64.0 73.6 0.680(0.549~0.811) 0.006 SPD(cm2) 3.53 64.0 75.9 0.728(0.619~0.837) 0.001 注:FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;AUC为曲线下面积;CI为置信区间;SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 3 18F-FDG PET/CT参数预测112例化疗中期DLBCL患者OS期的临界值
Table 3. Cut-off values of 18F-FDG PET/CT parameters for predicting overall survival in 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
参数 临界值 灵敏度(%) 特异度 (%) AUC(95%CI) P值 SUVmax 3.75 50.0 87.8 0.727(0.578~0.877) 0.006 TMTV(cm3) 17.80 57.1 86.7 0.686(0.512~0.861) 0.025 TTLG(g) 19.05 71.4 81.6 0.727(0.559~0.896) 0.006 SPD(cm2) 5.67 71.4 80.6 0.757(0.622~0.891) 0.002 注: FDG为氟脱氧葡萄糖;PET为正电子发射断层显像术;CT为计算机体层摄影术;DLBCL为弥漫性大B细胞淋巴瘤;OS为总生存;AUC为曲线下面积;CI为置信区间;SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 4 影响112例化疗中期DLBCL患者PFS期的多因素分析
Table 4. Multivariate analysis of progression-free survival of 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
因素 β值 Wald值 HR值 95%CI P值 年龄 −1.107 6.952 0.331 0.145~0.753 0.008 ECOG评分 −1.339 9.827 0.262 0.113~0.605 0.002 Deauville评分 −0.537 0.980 0.585 0.202~1.693 0.322 IPI评分 −0.418 0.147 0.658 0.078~5.566 0.701 NCCN-IPI评分 −0.183 0.074 1.200 0.321~4.489 0.786 SUVmax −0.342 0.280 0.711 0.201~2.517 0.596 TMTV −0.462 0.104 0.630 0.038~10.482 0.747 TTLG −1.269 8.320 0.281 0.119~0.666 0.004 SPD 0.062 0.007 1.064 0.256~4.422 0.932 注:DLBCL为弥漫性大B细胞淋巴瘤;PFS为无进展生存;CI 为置信区间;ECOG为美国东部肿瘤协作组;IPI为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数; SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和 表 5 影响112例化疗中期DLBCL患者OS期的多因素分析
Table 5. Multivariate analysis of overall survival of 112 patients with diffuse large B-cell lymphoma in the middle stage of chemotherapy
因素 β值 Wald值 HR值 95%CI P值 年龄 −0.237 0.795 0.789 0.469~1.328 0.372 ECOG评分 −0.364 1.580 0.695 0.394~1.226 0.209 Deauville评分 −0.312 0.918 0.732 0.387~1.385 0.338 IPI评分 −0.033 0.007 0.967 0.437~2.138 0.094 NCCN-IPI评分 −0.015 0.001 0.985 0.310~3.129 0.980 SUVmax 0.427 1.565 1.532 0.785~2.990 0.211 TMTV −0.748 1.386 0.437 0.136~1.644 0.239 TTLG 0.502 1.336 1.652 0.705~3.872 0.248 SPD 0.654 5.686 1.992 1.123~3.290 0.017 LDH水平 −0.521 4.174 0.594 0.360~0.979 0.041 注:DLBCL为弥漫性大B细胞淋巴瘤;OS为总生存;CI为置信区间;ECOG为美国东部肿瘤协作组;IPI为国际预后指数;NCCN-IPI为美国国家综合癌症网络-国际预后指数; SUVmax为最大标准化摄取值;TMTV为总的代谢肿瘤体积;TTLG为总的糖酵解总量;SPD为最大垂直径乘积之和;LDH为乳酸脱氢酶 -
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