Sakurai Masatoshi, Toyama Takaaki, Kikuchi Taku, Kato Jun, Shimizu Takayuki, Koda Yuya, Karigane Daiki, Yamane Yusuke, Abe Ryohei, Yamazaki Rie, Nakazato Tomonori, Nakahara Tadaki, Jinzaki Masahiro, Okamoto Shinichiro, Mori Takehiko
Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Int J Hematol. 2018 Feb;107(2):194-200. doi: 10.1007/s12185-017-2337-7. Epub 2017 Oct 9.
Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) has been recommended as a complementary tool for the staging of various malignancies, including malignant lymphoma. PET findings often shift patients to higher stages and may affect treatment outcomes. In this study, we retrospectively compared staging and treatment outcomes of newly diagnosed diffuse large B-cell lymphoma (DLBCL) assessed by PET (n = 153) or gallium-67 scintigraphy (Ga) (n = 95). In total, Ga upstaged two (2.1%) of 95 patients, whereas PET upstaged 13 (8.5%) of 153 patients. Bone/bone marrow (15 vs. 4%, P = 0.01) and muscle lesion (5 vs. 0%, P = 0.03) were identified more frequently in the PET group than in the Ga group. The estimated 3-year overall and progression-free survival rates did not differ significantly in the two groups at any stage. However, patients with stage III disease tended to have better progression-free survival in the PET group than in the Ga group [92.3 (95% CI 56.6-98.9%) vs. 58.3% (95% CI 27.0-80.1%), P = 0.086]. These results suggest that PET has a greater potential in detecting musculoskeletal lesions of DLBCL as extranodal lesions than Ga, and may contribute to the optimal staging.
氟-18氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）已被推荐作为包括恶性淋巴瘤在内的各种恶性肿瘤分期的辅助工具。PET检查结果常常会使患者被归为更高分期，且可能影响治疗结果。在本研究中，我们回顾性比较了通过PET（n = 153）或镓-67闪烁扫描（Ga）（n = 95）评估的新诊断弥漫性大B细胞淋巴瘤（DLBCL）的分期及治疗结果。总共，Ga使95例患者中的2例（2.1%）分期上调，而PET使153例患者中的13例（8.5%）分期上调。PET组中骨/骨髓（15%对4%，P = 0.01）和肌肉病变（5%对0%，P = 0.03）的检出频率高于Ga组。在任何分期，两组的估计3年总生存率和无进展生存率均无显著差异。然而，III期疾病患者中，PET组的无进展生存率倾向于高于Ga组[92.3（95%CI 56.6 - 98.9%）对58.3%（95%CI 27.0 - 80.1%），P = 0.086]。这些结果表明，与Ga相比，PET在检测DLBCL作为结外病变的肌肉骨骼病变方面具有更大潜力，可能有助于实现最佳分期。
