Prognostic value of 18F-FDG PET/CT metabolic parameters in NK/T cell lymphoma
Received date: 2019-03-25
Online published: 2019-06-25
目的: 评估18F-FDG PET/CT检查的代谢参数[最大标准摄取值(maximum standardized uptake value,SUVmax)、肿瘤代谢体积(metabolic tumour volume,MTV)、肿瘤糖酵解负荷(total lesion glycolysis,TLG)]在自然杀伤(natural killer,NK)/T细胞淋巴瘤患者预后评估中的价值。方法: 回顾性分析27例经病理确诊的NK/T细胞淋巴瘤患者,患者均在治疗前进行了基线PET/CT检查,随后接受相同方案治疗,中位随访23个月,每例患者在随访期间至少进行了一次治疗中或治疗末期的PET/CT评估。统计所有患者的PET/CT代谢参数SUVmax、MTV、TLG以无进展生存(progression-free survival,PFS)期及总生存(overall survival,OS)期为评价指标,进行Kaplan-Meier生存曲线分析。结果: 27例NK/T细胞淋巴瘤患者中5例出现了疾病进展,其中3例死亡。PET/CT检查参数中,MTV、TLG是NK/T细胞淋巴瘤患者PFS的预测因子,MTV>16.97 cm3及TLG>74.70×103预示疾病进展(MTV,P=0.013;TLG,P=0.029),SUVmax则无法预测PFS(P=0.661)。然而,这3项代谢参数均无法预测患者的OS(SUVmax,P=0.293;MTV,P=0.198;TLG,P=0.108)。结论: 18F-FDG PET/CT代谢参数MTV、TLG可能有助于预测NK/T细胞淋巴瘤患者的PFS,而无法预测其OS;SUVmax则在NK/T细胞淋巴瘤预后评估中的价值不大。
关键词: 自然杀伤/T细胞淋巴瘤; 18F-FDG PET/CT; 预后价值
沈文斌, 郭睿, 李彪 . 18F-FDG PET/CT代谢参数在NK/T细胞淋巴瘤预后价值的评估[J]. 诊断学理论与实践, 2019 , 18(03) : 349 -352 . DOI: 10.16150/j.1671-2870.2019.03.020
Objective: To analyze the prognostic value of metabolic parameters of 18F-FDG PET/CT examination [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] in patients with natural killer (NK)/T-cell lymphoma. Methods: A retrospective analysis of 27 patients with pathologically confirmed NK/T-cell lymphoma who underwent baseline PET/CT before treatment and then receiving the same treatment was performed. The median follow-up was 23 months. Each patient had at least one PET/CT re-assessment during follow-up or at the end of treatment. The PET/CT metabolic parameters SUVmax, MTV and TLG were analyzed statistically. The Kaplan-Meier survival curve was used to assess the progression-free survival (PFS) and overall survival (OS). Results: Of the 27 patients, 5 had disease progression and 3 of them died. Among the PET/CT parameters, MTV and TLG were the predictors of PFS in patients with NK/T-cell lymphoma (MTV: P=0.013, TLG: P=0.029), while SUVmax could not predict PFS (P=0.661). However, none of the 3 metabolic parameters could predict the OS (SUVmax, P=0.293; MTV, P=0.198; TLG, P=0.108). Conclusions: 18F-FDG PET/CT metabolic parameters MTV, TLG may help predicting PFS in patients with NK/T-cell lymphoma, but cannot predict OS; SUVmax is of little value in prognostic prediction of NK/T-cell lymphoma
Key words: Natural killer/T-cell lymphoma; 18F-FDG PET/CT; Prognostic value
[1] | Au WY, Ma SY, Chim CS, et al. Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years[J]. Ann Oncol, 2005, 16(2):206-214. |
[2] | Fujita M, Yamashiro K, Ichinohasama R, et al. The world health organization classification of malignant lymphomas in japan: incidence of recently recognized entities. Lymphoma Study Group of Japanese Pathologists[J]. Pathol Int, 2000, 50(9):696-702. |
[3] | Chen CY, Yao M, Tang JL, et al. Chromosomal abnormalities of 200 Chinese patients with non-Hodgkin's lymphoma in Taiwan: with special reference to T-cell lymphoma[J]. Ann Oncol, 2004, 15(7):1091-1096. |
[4] | Lee J, Suh C, Park YH, et al. Extranodal natural killer T-cell lymphoma, nasal-type: a prognostic model from a retrospective multicenter study[J]. J Clin Oncol, 2006, 24(4):612-618. |
[5] | Suzuki R, Takeuchi K, Ohshima K, et al. Extranodal NK/T-cell lymphoma: diagnosis and treatment cues[J]. Hematol Oncol, 2008, 26(2):66-72. |
[6] | Yamaguchi M, Suzuki R, Oguchi M. Advances in the treatment of extranodal NK/T-cell lymphoma, nasal type[J]. Blood, 2018, 131(23):2528-2540. |
[7] | Tse E, Kwong YL. Practical management of natural killer/T-cell lymphoma[J]. Curr Opin Oncol, 2012, 24(5):480-486. |
[8] | Cheson BD. Role of functional imaging in the management of lymphoma[J]. J Clin Oncol, 2011, 29(14):1844-1854. |
[9] | Yi JH, Kim SJ, Choi JY, et al. 18F-FDG uptake and its clinical relevance in primary gastric lymphoma[J]. Hematol Oncol, 2010, 28(2):57-61. |
[10] | Chang Y, Fu X, Sun Z, et al. Utility of baseline, interim and end-of-treatment 18F-FDG PET/CT in extranodal natural killer/T-cell lymphoma patients treated with L-asparaginase/pegaspargase[J]. Sci Rep, 2017, 7:41057. |
[11] | Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group[J]. J Clin Oncol, 2014, 32(27):3048-3058. |
[12] | Suh C, Kang YK, Roh JL, et al. Prognostic value of tumor 18F-FDG uptake in patients with untreated extra-nodal natural killer/T-cell lymphomas of the head and neck[J]. J Nucl Med, 2008, 49(11):1783-1789. |
[13] | Cottereau AS, Buvat I, Kanoun S, et al. Is there an optimal method for measuring baseline metabolic tumor vo-lume in diffuse large B cell lymphoma?[J]. Eur J Nucl Med Mol Imaging, 2018, 45(8):1463-1464. |
[14] | Kim CY, Hong CM, Kim DH, et al. Prognostic value of whole-body metabolic tumour volume and total lesion glycolysis measured on 18F-FDG PET/CT in patients with extranodal NK/T-cell lymphoma[J]. Eur J Nucl Med Mol Imaging, 2013, 40(9):1321-1329. |
[15] | Lin N, Song Y, Zheng W, et al. A prospective phase Ⅱ study of L-asparaginase- CHOP plus radiation in newly diagnosed extranodal NK/T-cell lymphoma, nasal type[J]. J Hematol Oncol, 2013, 6:44. |
[16] | Jaccard A, Gachard N, Marin B, et al. Efficacy of L-asparaginase with methotrexate and dexamethasone (AspaMetDex regimen) in patients with refractory or relap-sing extranodal NK/T-cell lymphoma, a phase 2 study[J]. Blood, 2011, 117(6):1834-1839. |
[17] | Xu PP, Xiong J, Cheng S, et al. A Phase II Study of Methotrexate, Etoposide, Dexamethasone and Pegaspargase Sandwiched with Radiotherapy in the Treatment of Newly Diagnosed, Stage IE to IIE Extranodal Natural-Killer/T-Cell Lymphoma, Nasal-Type[J]. EBioMedicine, 2017, 25:41-49. |
/
〈 |
|
〉 |