Value of 18F-FDG PET/CT and bone marrow biopsy in assessing bone marrow involvement in T-cell lymphoma
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摘要: 目的 研究18F-FDG PET/CT(简称PET/CT)与骨髓活检(BMB)对初诊T细胞淋巴瘤(TCL)患者骨髓浸润的诊断效能以及预后价值，评估PET/CT能否替代BMB成为TCL患者骨髓浸润的诊断手段。方法 回顾性分析2015年4月—2022年9月初诊的56例接受PET/CT和BMB的TCL患者，观察PET/CT与BMB检出骨髓浸润的灵敏度、特异度、阳性预测值、阴性预测值、漏诊率；比较PET/CT阳性与阴性患者、BMB阳性与阴性患者的总生存期(OS)、血常规的差异。结果 56例患者中共检出存在骨髓浸润者22例(39.3%)，其中PET/CT检出16例(28.6%)，BMB检出12例(21.4%)。PET/CT与BMB检出骨髓浸润的灵敏度分别为72.7%、54.5%，特异度分别为100.0%、100.0%，阳性预测值分别为100.0%、100.0%，阴性预测值分别为85.0%、77.3%，漏诊率分别为27.3%、45.5%。PET/CT阳性与阴性患者OS比较，差异无统计学意义(P=0.311)，BMB阳性与BMB阴性患者中位OS分别为13.9个月、89.0个月，BMB阴性患者OS明显延长(P＝0.047)。PET/CT阳性与阴性、BMB阳性与阴性患者血常规比较差异无统计学意义(P>0.05)。结论 T细胞淋巴瘤患者诊断骨髓浸润需要PET/CT与BMB互相补充。
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关键词:
- T细胞淋巴瘤 /
- 18F-FDG PET/CT /
- 骨髓活检 /
- 骨髓浸润
Abstract: Objective To compare the diagnostic performance and prognostic value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT) and bone marrow biopsy(BMB) for detection of bone marrow involvement in patients with newly diagnosed T-cell lymphoma(TCL) and then determine whether PET/CT can replace BMB for bone marrow assessment.Methods Fifty-six TCL patients during April 2015 and September 2022 undergoing PET/CT and BMB were retrospectively analyzed. Sensitivity, specificity, positive predictive value, negative predictive value, omission diagnostic rate of both techniques was analyzed. Differences of overall survival(OS) and blood routine examination were compared between PET/CT-positive and PET/CT-negative groups as well as BMB-positive and BMB-negative groups.Results Bone marrow involvement was detected in 22 patients(39.3%) including 16 cases(28.6%) by PET/CT cases and 12 cases(21.4%) by BMB. For PET/CT and BMB, the sensitivity was 72.7% and 54.5%, the specificity was 100.0% and 100.0%, the positive predictive value was 100.0% and 100.0%, the negative predictive value was 85.0% and 77.3%, the omission diagnostic rate was 27.3% and 45.5%, respectively. There was no difference on OS between PET/CT-positive and PET/CT-negative cases(P＝0.311). The median OS was 13.9 months and 89.0 months for BMB-positive and BMB-negative group respectively(P＝0.047). There was no difference in blood routine examination between PET/CT-positive and PET/CT-negative groups, nor between BMB-positive subgroup and BMB-negative groups(P>0.05).Conclusion Both PET/CT and BMB are needed for assessing bone marrow involvement in TCL patients.-
Key words:
- T-cell lymphoma /
- 18F-FDG PET/CT /
- bone marrow biopsy /
- bone marrow involvement
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表 3 PET/CT阳性与PET/CT阴性患者血常规比较
X±S 组别 白细胞计数/(×109/L) 血红蛋白/(g/L) 血小板计数/(×109/L) PET/CT阳性(n=16) 9.30±6.25 111.75±37.06 216.19±154.75 PET/CT阴性(n=40) 7.31±5.51 124.75±21.97 238.60±115.09 F 0.293 10.355 2.896 P 0.247 0.204 0.554 
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表 4 BMB阳性与BMB阴性患者血常规比较
X±S 组别 白细胞计数/(×109/L) 血红蛋白/(g/L) 血小板计数/(×109/L) BMB阳性(n=12) 8.90±8.49 120.42±28.86 198.33±115.07 BMB阴性(n=44) 7.60±4.84 121.20±27.36 241.43±129.26 F 1.340 0.051 0.003 P 0.494 0.931 0.300
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