Value of 18F-FDG PET/CT Parameters and Deauville 5-point Scoring in Efficacy Evaluation and Prognosis Prediction of Diffuse Large B Cell Lymphoma Patients
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摘要:目的
探讨最大标准化摄取值（SUVmax）、SUVmax下降值（ΔSUVmax）、肿瘤代谢体积（MTV）、BCL-2、BCL-6蛋白表达对弥漫大B细胞淋巴瘤（DLBCL）患者预后的预测价值。
方法回顾性分析55例DLBCL患者的18F-FDG PET/CT表现，应用18F-FDG PET/CT Deauville五分法（5-PS）评估中期化疗效果，应用卡方检验分析SUVmax、ΔSUVmax、MTV、BCL-2、BCL-6蛋白表达和疗效的相关性；用Kaplan-Meier生存分析和Cox回归法分析△SUVmax、Deauville标准、MTV、BCL-2、BCL-6蛋白对患者2年无疾病进展生存期（PFS）的预测价值。
结果SUVmax与中期疗效无明显相关性（P > 0.05）；ΔSUVmax、MTV、BCL-2、BCL-6和疗效显著相关（P=0.029, 0.005, 0.001, 0.014）；单因素和多因素分析ΔSUVmax < 10.6、MTV < 30.1 cm3、Deauville < 4分、BCL-6（-）各组2年PFS和ΔSUVmax≥10.6、MTV≥30.1 cm3、Deauville≥4分、BCL-6（+）各组比较差异均有统计学意义（P < 0.05），BCL-2组仅单因素分析2年PFS差异有统计学意义（P=0.039）。
结论ΔSUVmax、MTV和中期疗效呈负相关，BCL-2（-）、BCL-6（-）患者显示出好的疗效；ΔSUVmax、MTV、Deauville标准、BCL-6蛋白均是DLBCL患者2年PFS的独立影响因素。
Abstract:ObjectiveTo analyze the prognostic value of SUVmax, ΔSUVmax, MTV and BCL-2 and BCL-6 expression on DLBCL patients.
MethodsWe retrospectively analyzed the 18F-FDG PET/CT manifestation of 55 DLBLC patients, and evaluated the middle-stage chemotherapy effect with 5-PS by 18F-FDG PET/CT scan. Chi-square test was used for analysing the correlation of the chemotherapy efficacy with SUVmax, ΔSUVmax, MTV and the expression of BCL-2 and BCL-6. Kaplan-Meier analysis and Cox regression analysis were used for the predictive value of ΔSUVmax, MTV, Deauville score and the expression of BCL-2 and BCL-6 on the 2-years PFS of DLBCL patients.
ResultsThere was no correlation between SUVmax and the middle-stage chemotherapy effect (P > 0.05); ΔSUVmax, MTV and the expression of BCL-2 and BCL-6 were positively correlated with chemotherapy effect (P=0.029, 0.005, 0.001, 0.014). By univariate and multivariate analyses, there were statistical differences in 2-years PFS between ΔSUVmax < 10.6, MTV < 30.1 cm3, Deauville score < 4, BCL-6(-) groups and ΔSUVmax≥10.6, MTV≥30.1 cm3, Deauville score≥4, BCL-6(+) groups (P < 0.05). There was statistical difference in 2-years PFS of the patients with BCL-2 by univariate analysis (P=0.039).
ConclusionThere are negatively correlation between ΔSUVmax, MTV and the middle-stage chemotherapy effect. Patients with BCL2(-) and BCL-6(-) have good efficacy. ΔSUVmax, MTV, Deauville score and BCL-6 are independent prognostic factors for the 2-years PFS of DLBCL patients.
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Key words:
- Diffuse large B-cell lymphoma /
- FDG /
- PET/CT /
- SUVmax /
- Prognosis
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作者贡献杨明：病例资料收集、数据统计分析及论文撰写冯彦林：指导论文写作与修改冼伟均、鲁胜男：数据统计分析王颖、李雯：病例资料收集黄克敏：临床显像及质量控制
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图 1 DLBCL患者多个代谢参数对2年PFS的影响
Figure 1 Effect of multiple parameters on 2 year PFS of DLBCL patients
DLBCL patients with ΔSUVmax≥10.6 (A), MTV < 30.1 cm3(B), Deauville's < 4 (C), BCL-2(-) (D) and BCL-6(-) (E) had higher 2-year PFS than those with ΔSUVmax < 10.6 (P=0.008), MTV≥30.1 (P=0.005), Deauville's≥4 (P=0.020), BCL-2(+) (P=0.035) and BCL-6(+) (P=0.004), respectively. PFS: progression-free survival.
表 1 SUVmax、BCL-2、BCL-6和DLBCL患者中期疗效的相关性
Table 1 Correlation of middle-stage chemotherapy effect with SUVmax, BCL-2 and BCL-6 expression
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表 2 多参数对DLBCL患者2年PFS预测价值的Cox回归分析
Table 2 Prognostic value of multiple parameters on 2-year PFS of DLBCL patients: Cox regression analysis
下载: 导出CSV
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