Lee Jeong Won, Lee Sang Cheol, Kim Han Jo, Lee Sang Mi
Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Korea.
Hell J Nucl Med. 2017 Jan-Apr;20(1):17-25. doi: 10.1967/s002449910502. Epub 2017 Mar 20.
The study evaluated the significance of 18F fluorodeoxyglucose (F-FDG) uptake of bone marrow (BM) for predicting progression-free survival (PFS) in lymphoma patients without BM involvement.
Ninety-five patients with histopathologically proven lymphoma, 7 Hodgkin's lymphoma and 88 non-Hodgkin's lymphoma, who underwent F-FDG positron emission tomography/computed tomography (PET/CT) and BM biopsy for staging work-up and 40 normal subjects were retrospectively enrolled. Maximal F-FDG uptake of lymphoma (Lmax), mean F-FDG uptake of BM (BM SUV) and BM-to-liver uptake ratio (BLR) were measured. Prognostic value of BM SUV and BLR for predicting PFS were assessed.
Of the 95 patients, 35 (36.8%) were histopathologically or clinically diagnosed with BM involvement of lymphoma. There were significant differences of BLR among lymphoma patients with/without BM involvement and normal subjects (P<0.05). For all patients, high risk indicated by International Prognostic Index (IPI) score and Lmax were significantly associated with PFS on multivariate analysis (P<0.05). For 60 patients without BM involvement, BM SUV and BLR were independent prognostic factors for PFS along with performance status and Lmax (p<0.05). Among patients without BM involvement, high F-FDG uptake of BM was associated with significantly worse PFS than low F-FDG uptake of BM, with no significant difference in PFS apparent compared to patients with BM involvement.
In lymphoma patients without BM involvement, F-FDG uptake of BM was significantly associated with worse PFS. Patients with high F-FDG uptake of BM showed similar prognosis to those with BM involvement.
本研究评估了18F氟脱氧葡萄糖（F-FDG）摄取对无骨髓受累的淋巴瘤患者无进展生存期（PFS）的预测意义。
回顾性纳入95例经组织病理学证实的淋巴瘤患者，其中7例霍奇金淋巴瘤和88例非霍奇金淋巴瘤，这些患者接受了F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）和骨髓活检以进行分期检查，另外还纳入了40例正常受试者。测量淋巴瘤的最大F-FDG摄取量（Lmax）、骨髓的平均F-FDG摄取量（BM SUV）和骨髓与肝脏摄取比值（BLR）。评估BM SUV和BLR对预测PFS的预后价值。
95例患者中，35例（36.8%）经组织病理学或临床诊断为淋巴瘤骨髓受累。淋巴瘤有/无骨髓受累患者与正常受试者之间的BLR存在显著差异（P<0.05）。对所有患者而言，多因素分析显示国际预后指数（IPI）评分和Lmax所提示的高风险与PFS显著相关（P<0.05）。对于60例无骨髓受累的患者，BM SUV和BLR连同体能状态和Lmax是PFS的独立预后因素（p<0.05）。在无骨髓受累的患者中，骨髓F-FDG摄取高者的PFS明显比骨髓F-FDG摄取低者差，与有骨髓受累的患者相比，PFS无明显差异。
在无骨髓受累的淋巴瘤患者中，骨髓F-FDG摄取与较差的PFS显著相关。骨髓F-FDG摄取高的患者与有骨髓受累的患者预后相似。
