Department of Medicine, Division of Hematology/Oncology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, Florida 33136, USA.
Am J Hematol. 2011 Oct;86(10):841-5. doi: 10.1002/ajh.22126. Epub 2011 Aug 22.
Positron emission tomography (PET) scans are widely used in patients with lymphoma but little is known about their utility in mantle cell lymphoma (MCL). MCL patients were included from two prospective trials and one observational study at our institution. A total of 276 PET scans were performed among 52 patients. After a median follow-up of 37.5 months, the 3-year event-free survival (EFS) and overall survival (OS) were 73% (95% confidence interval [CI]: 61-85%) and 92% (95% CI 85-100%), respectively. There were 34 pretreatment PET scans, 26 interim, 28 end-of-treatment, 162 surveillance, and 26 scans at relapse or beyond. Pretreatment PETs were positive in 94%. A negative interim or end-of-therapy PET scan was not significantly associated with better EFS or OS, but no deaths were observed in patients who had a negative interim or end-of-therapy PET. Surveillance PET scans had a high false positive rate (35%) and low positive predictive value (8%). PET scans contributed to an earlier diagnosis of relapse in only two out of the 18 patients (11%) who relapsed. PET scans did not meaningfully contribute to staging or surveillance of MCL patients in this study. There was a trend toward improved survival in patients who had a negative end-of-therapy PET scan.
正电子发射断层扫描（PET）扫描在淋巴瘤患者中广泛应用，但对于套细胞淋巴瘤（MCL）患者的应用知之甚少。我们从本机构的两项前瞻性试验和一项观察性研究中纳入了 MCL 患者。52 例患者共进行了 276 次 PET 扫描。中位随访 37.5 个月后，3 年无事件生存率（EFS）和总生存率（OS）分别为 73%（95%置信区间：61-85%）和 92%（95%置信区间 85-100%）。有 34 次预处理 PET 扫描、26 次中期、28 次治疗结束、162 次随访和 26 次复发或更晚期的扫描。预处理 PET 阳性率为 94%。中期或治疗结束时阴性 PET 扫描与更好的 EFS 或 OS 无显著相关性，但在中期或治疗结束时阴性 PET 扫描的患者中未观察到死亡。随访 PET 扫描的假阳性率较高（35%），阳性预测值较低（8%）。在 18 例复发患者中，仅 2 例（11%）通过 PET 扫描更早地诊断出复发。在这项研究中，PET 扫描对 MCL 患者的分期或随访没有明显作用。治疗结束时阴性 PET 扫描的患者生存有改善的趋势。
