Zhou Zhiyuan, Chen Changying, Li Xiang, Li Zhaoming, Zhang Xudong, Chang Yu, Lu Lisha, Cui Yingying, Ma Yaozhen, Zhang Mingzhi
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou, 450000, China.
Ann Hematol. 2015 Jun;94(6):963-7. doi: 10.1007/s00277-014-2289-4. Epub 2014 Dec 30.
Evaluation of bone marrow involvement (BMI) by conventional bone marrow biopsy (BMB) can generate false-negative results if marrow disease is focal. The sensitivity of 18F-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) in assessing BMI in extranodal NK/T cell lymphoma (ENKL) has not been determined. We retrospectively collected clinical data from a series of 55 patients with newly diagnosed ENKL, who have received both FDG-PET/CT and BMB prior to treatment. BMB results were used as reference standard. Twelve patients (21.8 %) were considered positive lymphomatous infiltration by FDG-PET/CT (PET-CT/BM+), and five patients (9 %) were identified positive by BMB (BMB/BM+). There was a discordant result in seven patients who were PET-CT/BM+ but BMB/BM-. The sensitivity and specificity of FDG-PET/CT for identifying BMI were 100 and 86 %, respectively. Then, we analyzed the overall survival (OS) and progression-free survival (PFS) of patients who were PET-CT/BM+ and PET-CT/BM-. The median follow-up time was 16 months (range, 3 to 43 months). PET-CT/BM+ patients possessed worse 2-year OS than PET-CT/BM- patients (84.8 vs 67.9 %, P < 0.05). The estimated 2-year PFS for PET-CT/BM- and PET-CT/BM+ patients were 72.7 and 41.9 % (P < 0.05), respectively. However, it was hard to conclude that patients who were PET-CT/BM+ had similar survivals to advanced-stage patients due to the low number of patients who were PET-CT/BM+. In conclusion, FDG-PET/CT can complementally detect positive BMI patients missed by BMB in ENKL. The utility of FDG-PET/CT for defining bone marrow status has important prognostic value.
如果骨髓病变为局灶性，通过传统骨髓活检（BMB）评估骨髓受累情况（BMI）可能会产生假阴性结果。18F-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）评估结外NK/T细胞淋巴瘤（ENKL）中BMI的敏感性尚未确定。我们回顾性收集了55例新诊断的ENKL患者的临床资料，这些患者在治疗前均接受了FDG-PET/CT和BMB检查。BMB结果用作参考标准。12例患者（21.8%）经FDG-PET/CT检查被认为存在阳性淋巴瘤浸润（PET-CT/BM+），5例患者（9%）经BMB检查确定为阳性（BMB/BM+）。7例患者结果不一致，他们是PET-CT/BM+但BMB/BM-。FDG-PET/CT识别BMI的敏感性和特异性分别为100%和86%。然后，我们分析了PET-CT/BM+和PET-CT/BM-患者的总生存期（OS）和无进展生存期（PFS）。中位随访时间为16个月（范围3至43个月）。PET-CT/BM+患者的2年OS比PET-CT/BM-患者差（84.8%对67.9%，P<0.05）。PET-CT/BM-和PET-CT/BM+患者的估计2年PFS分别为72.7%和41.9%（P<0.05）。然而，由于PET-CT/BM+患者数量较少，很难得出PET-CT/BM+患者的生存期与晚期患者相似的结论。总之，FDG-PET/CT可以补充检测出BMB遗漏的ENKL中BMI阳性患者。FDG-PET/CT用于定义骨髓状态的效用具有重要的预后价值。
