Explore the clinical value of 18F-FDG PET/CT SUVmax,SUVsum and pathological Ki67 expression in non-Hodgkin’s lymphoma
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摘要: 目的:18F-FDG PET/CT对淋巴瘤的临床分期及预后判断有重要的临床价值,探讨18F-FDG PET/CT最大标准化摄取值(SUVmax)、最大标准化摄取值总和(SUVsum)及病理Ki67表达等在非霍奇金淋巴瘤(NHL)中的临床应用价值有一定的临床意义。方法:收集2014年6月—2019年6月我院收治的260例NHL患者的临床资料,统计分析SUVmax与NHL临床特征、病理类型的关系,绘制受试者操作特征曲线分析SUVmax、Ki67%联合指标对NHL侵袭性的诊断价值,并应用中期18F-FDG PET/CT半定量SUV降幅法评估其中57例弥漫大B细胞淋巴瘤(DLBCL)患者的预后。结果:SUVmax与NHL的IPI评分、乳酸脱氢酶、β2微球蛋白有关,与Ki67%呈正相关(P＜0.01);DLBCL的SUVmax明显高于套细胞淋巴瘤的SUVmax(P＜0.01),高级别滤泡性淋巴瘤与低级别滤泡性淋巴瘤的SUVmax值比较,差异无统计学意义(P>0.05);SUVmax与Ki67%联合预测NHL侵袭性的价值高于单独应用SUVmax(P＜0.01);SUVmax下降幅度≥88.6%的无进展生存期和总生存期优于SUVmax下降幅度＜88.6%的DLBCL患者,SUVsum下降幅度≥90.7%的无进展生存期优于SUVsum下降幅度＜90.7%的患者(P＜0.05)。结论:SUVmax不能精确区分NHL淋巴瘤病理亚型,利用Ki67%与SUVmax联合评估NHL的侵袭性比单独应用SUVmax更加有利,中期评估PET/CT的半定量SUVmax、SUVsum降幅比例可以影响DLBCL患者预后。Abstract: Objective: 18F-FDG PET/CT has an important clinical value in clinical staging and prognosis evaluation of lymphoma, we want to investigate the value of 18F-FDG PET/CT maximum standardized uptake value(SUVmax), sum of the maximum standardized uptake value(SUVsum) and pathological Ki67 expression in the diagnosis and prognosis of non-Hodgkin's lymphoma(NHL).Methods: The clinical data of 260 NHL patients admitted to our hospital from June 2014 to June 2019 were collected. We analyzed the relationship among SUVmax, NHL clinical characteristics as well as pathological types, and drew the receiver operating characteristics curve to analysis the diagnostic value of SUVmax and Ki67% combined indicators for NHL aggressiveness, and evaluated the prognosis of 57 diffuse large B-cell lymphoma(DLBCL) patients using the mid-term 18F-FDG PET/CT semi-quantitative SUV reduction method.Results: SUVmax was related to IPI score of NHL, lactate dehydrogenase, β2-microglobulin, and positively correlated with Ki67%(P＜0.01). The SUVmax of DLBCL was significantly higher than that of mantle cell lymphoma(P＜0.01). There was no significant difference in SUVmax between high-grade follicular lymphoma and low-grade follicular lymphoma(P>0.05). The value of SUVmax and Ki67% in predicting NHL aggressiveness was higher than that of SUVmax alone(P＜0.01). The progression free survival and overall survival with a decrease of SUVmax≥88.6% were better than DLBCL patients with a decrease of SUVmax＜88.6%, and the progression free survival with a decrease of SUVsum≥90.7% was better than DLBCL patients with a decrease of SUVsum＜90.7%(P＜0.05).Conclusion: SUVmax cannot accurately distinguish the pathological subtypes of NHL lymphoma. Using Ki67% and SUVmax to evaluate the aggressiveness of NHL is more advantageous than using SUVmax alone. Mid-term assessment of PET/CT semi-quantitative SUVmax, SUVsum reduction ratio can affect the prognosis of DLBCL patients.
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Key words:
- PET/CT /
- Ki67 expression /
- non-Hodgkin's lymphoma /
- diffuse large B-cell lymphoma /
- prognosis
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