摘要
目的探讨结合影像(PET/CT)、病理(免疫分型)及临床(国际预后指数,IPI)建立的预后评估模型在弥漫大B细胞淋巴瘤(DLBCL)中的应用。资料与方法收集经病理确诊的270例DLBCL患者的免疫分型[是否生发中心(GCB)来源]、IPI评分等,于化疗前及化疗后2个周期行^(18)F-FDGPET/CT成像,运用5分评分法(5PS)及最大标准化摄取值减少率法(△SUVmax)分析成像结果。通过随访分析患者的疗效及无进展生存率(PFS)、总生存率(OS)在组合预后模型(影像、病理、临床)与单一模型的差异。结果中位随访时间46个月。生存曲线显示单一模型中IPI、5PS及△SUVmax法PFS及OS组间差异有统计学意义(P<0.05),GCB组与Non-GCB组免疫分型差异无统计学意义(P>0.05)。组合模型PFS与OS显示不同组合模式高、中、低风险3组间差异均有统计学意义(P=0.000)。结论结合影像、病理及临床多参数建立的评估模型对DLBCL预后评估有显著意义。
Purpose The application of prognostic assessment model combined with imaging (PET/CT), pathology (immunophenotype) and clinical (International prognostic index, IPI) in diffuse large B cell lymphoma (DLBCL) was discussed. Materials and Methods The immunophenotype [whether germinal center B-cell like (GCB ) source] and IPI scores of 270 cases of DLBCL patients confirmed by pathology were collected, and 18 F-FDG PET/CT imaging was performed before and after two cycles of chemotherapy. The imaging results were analyzed by five-point scale (5PS) and maximum standard uptake value decrement method (△SUVmax). The differences in efficacy, progression free survival (PFS) and overall survival (OS) between the combined prognostic model (imaging, pathology and clinical) and the single model were analyzed by follow-up. Results The median follow-up time was 46 months. The survival curves showed statistically significant differences among IPI, 5PS and △SUVmax methods in the single model between the PFS and OS groups (P<0.05), and there was no statistically significant differences between the immunophenotype GCB group and the Non-GCB group (P>0.05). In addition, the PFS and OS in combined model showed that the differences among the three groups with high, medium and low risks of different combined models were statistically significant (P=0.000). Conclusion The assessment model combined with imaging, pathology and clinical parameters is of great significance for the prognosis assessment of DLBCL.
作者
朱海燕
李菲
赵瑜
王全顺
王瑞民
ZHU Haiyan;LI Fei;ZHAO Yu;WANG Quanshun;WANG Ruimin(Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing 100853, China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2019年第4期298-301,308,共5页
Chinese Journal of Medical Imaging
基金
国家自然科学基金项目(81450023)
中国博士后基金(2014M552583)
