Oh Min-Young, Oh Sang-Bo, Seoung Hyeog-Gyu, Kim Ji-Hye, Kim Sang-Mi, Kim Tae-Kyun, Song Moo-Kon, Shin Ho-Jin, Chung Joo-Seop
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Korean J Hematol. 2012 Sep;47(3):207-12. doi: 10.5045/kjh.2012.47.3.207. Epub 2012 Sep 25.
Maximum standardized uptake value (SUVmax) and maximum tumor diameter (MTD) have been shown to reflect survival outcome in diffuse large B cell lymphoma (DLBCL). However, applying these values to primary extranodal DLBCL is difficult because they are separate nosological entities with differences in genetic origin. We therefore decided to evaluate whether SUVmax and MTD on 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18-FDG) positron emission tomography (PET) would affect the survival outcome in primary extranodal DLBCL.
From October 2005 to November 2010, 76 primary extranodal DLBCL patients receiving R-CHOP therapy were analyzed. All patients had undergone an initial 18-FDG PET/CT and conventional computed tomography (CT) of the neck, chest, abdomen, and pelvis for staging. Median follow-up period was 35 months.
The SUVmax and MTD cut-off values were 11.0 and 7.5 cm, respectively. SUVmax≥11.0 predicted a short progression free survival (PFS, P=0.002) and overall survival (OS, P=0.002). MTD≥7.5 cm was associated with poor PFS (P=0.003) and OS (P=0.003). High International Prognostic Index (IPI) was also associated with the survival outcome (PFS, P=0.046; OS, P=0.030). Multivariate analysis revealed that SUVmax≥11.0 (PFS, hazard ratio [HR]=10.813, P=0.024; OS, HR=6.312, P=0.015); MTD≥7.5 cm (PFS, HR=5.631, P=0.008; OS, HR=4.072, P=0.008); and high IPI (PFS, P=0.027; OS, P=0.046) were independent prognostic factors.
It appears that both MTD and SUVmax can be independent prognostic factors in primary extranodal DLBCL.
最大标准化摄取值（SUVmax）和最大肿瘤直径（MTD）已被证明可反映弥漫性大B细胞淋巴瘤（DLBCL）的生存结果。然而，将这些值应用于原发性结外DLBCL很困难，因为它们是具有不同遗传起源的独立疾病实体。因此，我们决定评估2-[氟-18]-氟-2-脱氧-D-葡萄糖（18-FDG）正电子发射断层扫描（PET）上的SUVmax和MTD是否会影响原发性结外DLBCL的生存结果。
对2005年10月至2010年11月期间接受R-CHOP治疗的76例原发性结外DLBCL患者进行分析。所有患者均接受了初始18-FDG PET/CT以及颈部、胸部、腹部和骨盆的传统计算机断层扫描（CT）以进行分期。中位随访期为35个月。
SUVmax和MTD的临界值分别为11.0和7.5 cm。SUVmax≥11.0预示无进展生存期（PFS，P = 0.002）和总生存期（OS，P = 0.002）较短。MTD≥7.5 cm与不良的PFS（P = 0.003）和OS（P = 0.003）相关。高国际预后指数（IPI）也与生存结果相关（PFS，P = 0.046；OS，P = 0.030）。多变量分析显示，SUVmax≥11.0（PFS，风险比[HR]=10.813，P = 0.024；OS，HR = 6.312，P = 0.015）；MTD≥7.5 cm（PFS，HR = 5.631，P = 0.008；OS，HR = 4.072，P = 0.008）；以及高IPI（PFS，P = 0.027；OS，P = 0.046）是独立的预后因素。
看来MTD和SUVmax均可作为原发性结外DLBCL的独立预后因素。
