Jiménez Londoño G A, García Vicente A M, Poblete García V M, Amo-Salas M, Calle Primo C, Ibañez García Á, Martínez Sanchís B, López-Fidalgo J F, Solano Ramos F, Martínez Hellín A, Díaz Morfa M, Soriano Castrejón Á
Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain.
Department of Nuclear Medicine, Hospital General Universitario de Ciudad Real, Spain.
Rev Esp Med Nucl Imagen Mol. 2016 Sep-Oct;35(5):298-305. doi: 10.1016/j.remn.2016.04.003. Epub 2016 Jun 14.
To analyze the relationship of clinical variables related to prognosis and tumor burden, with metabolic variables obtained in the staging (18)F-FDG PET/CT, and their value in the prognosis in follicular lymphoma (FL).
82 patients with FL, a (18)F-FDG PET/CT at diagnosis and a follow-up for a minimum of 12 months, were retrospectively enrolled in the present study. Clinical variables (Tumor grade, Follicular Lymphoma International Prognostic Index (FLIPI) and Tumor burden) were evaluated. Metabolic variables such as SUVmax in the highest hypermetabolic lesion, extralymphatic locations, number of involved lymph node locations, bone marrow (BM) involvement, PET stage and diameter of the biggest hypermetabolic lesion, were analyzed in order to establish a PET score and classify the studies in low, intermediate and high metabolic risk. Clinical and metabolic variables (included metabolic risk) were compared. The relation among all variables and disease-free survival (DFS) was studied.
The 28% of patients had a high-grade tumor. The 30.5% had FLIPI risk low, 29.3% intermediate y 40.2% high. The 42.7% presented a high tumor burden. The PET/CT was positive in 94% of patients. The tumor grade did not show significant relation with metabolic variable. FLIPI risk and tumor burden showed statistical relations with the SUV max and the PET score (p<0.008 and p=0.003 respectively). With respect to DFS, significant differences were detected for the PET stage and FLIPI risk (p=0.015 and p=0.047 respectively). FLIPI risk was the only significant predictor in Cox regression analysis, with a Hazard Ratio of 5.13 between high risk and low risk.
The present research highlights the significant relation between metabolic variables obtained with FDG PET/CT and clinical variables although their goal as an independent factor of prognosis was not demonstrated in the present work.
分析与预后和肿瘤负荷相关的临床变量与分期（18）F-FDG PET/CT 中获得的代谢变量之间的关系，以及它们在滤泡性淋巴瘤（FL）预后中的价值。
本研究回顾性纳入了 82 例 FL 患者，这些患者在诊断时进行了（18）F-FDG PET/CT 检查，并至少随访了 12 个月。评估了临床变量（肿瘤分级、滤泡性淋巴瘤国际预后指数（FLIPI）和肿瘤负荷）。分析了代谢变量，如最高代谢亢进病变中的 SUVmax、结外部位、受累淋巴结部位数量、骨髓（BM）受累情况、PET 分期以及最大代谢亢进病变的直径，以建立 PET 评分并将研究分为低、中、高代谢风险。比较了临床和代谢变量（包括代谢风险）。研究了所有变量与无病生存期（DFS）之间的关系。
28%的患者为高级别肿瘤。30.5%的患者 FLIPI 风险低，29.3%为中度，40.2%为高度。42.7%的患者呈现高肿瘤负荷。94%的患者 PET/CT 呈阳性。肿瘤分级与代谢变量无显著关系。FLIPI 风险和肿瘤负荷与 SUVmax 和 PET 评分存在统计学关系（分别为 p<0.008 和 p=0.003）。关于 DFS，PET 分期和 FLIPI 风险存在显著差异（分别为 p=0.015 和 p=0.047）。FLIPI 风险是 Cox 回归分析中唯一具有显著意义的预测因素，高风险与低风险之间的风险比为 5.13。
本研究强调了 FDG PET/CT 获得的代谢变量与临床变量之间的显著关系，尽管在本研究中未证明其作为独立预后因素的作用。
