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18F-FDG PET/CT Deauville评分及ΔSUVmax评估弥漫性大B细胞淋巴瘤化疗中期预后的价值

Value of 18F-FDG PET/CT Deauville score and ΔSUVmax in evaluating medium-term prognosis of patients with chemotherapy for diffuse large B-cell lymphoma

    摘要
  • 摘要:
    目的 探讨18氟-氟代脱氧葡萄糖正电子发射体层摄影技术/计算机体层摄影技术(18F-FDG PET/CT)显像Deauville评分和最大标准化摄取值的变化(ΔSUVmax)在弥漫性大B细胞淋巴瘤(DLBCL)化疗中期预后评估中的价值。
    方法 回顾性分析78例DLBCL患者化疗中期18F-FDG PET/CT图像资料。对ΔSUVmax、ΔSUVmax%进行受试者工作特征(ROC)曲线分析, 分别采用ΔSUVmax及ΔSUVmax%的最佳临界值、Deauville评分分组，并按免疫组化结果分为生发中心(GCB)型和非GCB型。进行Kaplan-Meier生存曲线和Cox回归分析，分析Deauville评分法和ΔSUVmax法的预后评估能力。
    结果 78例患者分为进展组24例和未进展组54例; 进展组ΔSUVmax均值为(3.42±9.90), 低于未进展组的(8.76±5.58), 差异有统计学意义(P < 0.05); 进展组中位数ΔSUVmax%为34.88%, 低于未进展组的78.16%, 差异有统计学意义(P < 0.01)。ΔSUVmax及ΔSUVmax%的曲线下面积(AUC)分别为0.667、0.882(P < 0.01), 分别以临界值7.95、67.34%分组, Kaplan-Meier分析显示2年无进展生存期(PFS)的差异有统计学意义(44.4%与82.4%, 33.3%与95.6%, P < 0.01)。Deauville < 4分(PET阴性)组的2年PFS为91.9%, 高于Deauville≥4分(PET阳性)组的48.8%, 差异有统计学意义(P < 0.01)。GCB型2年PFS为90.3%, 高于非GCB型的55.3%, 差异有统计学意义(P < 0.01)。Cox多因素分析显示ΔSUVmax%及免疫组化分型为独立预测因素(P < 0.01)。
    结论 Deauville评分法和ΔSUVmax法在DLBCL化疗中期预后评估中均有较高的价值, ΔSUVmax%及免疫组化分型为PFS的独立预测因素。

     

    Abstract:
    Objective To explore the value of 18 fluoro-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) display Deauville score and change of max standardized uptake value (ΔSUVmax) in evaluating medium-term prognosis of patients with chemotherapy for diffuse large B-cell lymphoma (DLBCL).
    Methods The 18F-FDG PET/CT images of 78 patients with DLBCL in the medium-term of chemotherapy were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to analyze the ΔSUVmax and ΔSUVmax%, the patients were divided into different groups according to optimal cut-off values of ΔSUVmax and ΔSUVmax% as well as Deauville score, and they were also divided into germinal center B-cell-like (GCB) type and non-GCB type. Kaplan-Meier survival curve and Cox regression analysis were performed to evaluate the ability of Deauville score and ΔSUVmax methods in prognosis.
    Results A total of 78 patients were divided into progressive group with 24 cases and non-progressive group with 54 cases; the mean value of ΔSUVmax was (3.42±9.90) in the progressive group, which was significantly lower than (8.76±5.58) in the non-progressive group (P < 0.05); the median value of ΔSUVmax% in the progressive group was 34.88%, which was significantly lower than 78.16% in the non-progressive group (P < 0.01). The area under the curve (AUC) of ΔSUVmax and ΔSUVmax% was 0.667 and 0.882 respectively (P < 0.01), and taking the cut-off values of 7.95 and 67.34% respectively as the grouping criteria, the Kaplan-Meier analysis showed that there were significant differences in 2-year progression-free survival (PFS) between groups (44.4% versus 82.4%, 33.3% versus 95.6%, P < 0.01). The 2-year PFS of Deauville < 4 (PET negative) group was 91.9%, which was significantly higher than 48.8% of Deauville≥4 (PET positive) group (P < 0.01). The 2-year PFS of GCB type was 90.3%, which was significantly higher than 55.3% of non-GCB type (P < 0.01). Cox multivariate analysis showed that ΔSUVmax% and immunohistochemical typing were the independent predictors (P < 0.01).
    Conclusion Both Deauville score and ΔSUVmax methods have high values in the medium-term prognostic evaluation of chemotherapy for DLBCL, and ΔSUVmax% and immunohistochemical typing were the independent predictors for PFS.

     

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