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初诊多发性骨髓瘤患者氟代脱氧葡萄糖正电子发射断层扫描/计算机体层成像与临床参数联合预测价值。

Predictive value of F-FDG PET/CT scanning in combination with clinical parameters in patients with newly diagnosed multiple myeloma.

机构信息

Department of Clinical Hematology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.

Department of Nuclear Medicine, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China.

出版信息

Eur J Haematol. 2018 Feb;100(2):189-197. doi: 10.1111/ejh.13006. Epub 2017 Dec 29.

Abstract

OBJECTIVE

To evaluate the association of F-2'-deoxy 2'-fluorodeoxyglucose ( F-FDG) PET/CT with clinical parameters in predicting patients with newly diagnosed multiple myeloma (MM).

METHODS

A total of 120 MM patients undergoing F-FDG PET/CT scanning were analyzed in a retrospective cohort study.

RESULTS

Based on multivariate analysis, β2M, LDH, number of focal lesions (FLs), and SUVmax were significantly correlated with OS. These 4 variables were used to construct a new staging system (NSS) based on the number of risk factors. NSS provided a better discrimination of risk between stages III and II than International staging system (ISS) (P < .001 vs P = .086). For OS, there was no significant difference among risk groups in Durie-Salmon (DS) stage (P > .05). Based on Spearman correlation analysis, the presence of lesions in appendicular skeleton, number of FLs, and SUVmax appeared to indicate advanced stage of MM. ROC curves which showed the combination of β2M with calcium got a specificity of 96.3% for lesions in appendicular skeleton, and LDH alone had 100% specificity in predicting the number of FLs, although the sensitivity was only 50%.

CONCLUSIONS

F-FDG PET/CT in combination with clinical parameters provided an accurate and simple method for risk stratification of patients with newly diagnosed MM.

摘要

目的

评估 F-2'-脱氧-2'-氟脱氧葡萄糖( F-FDG)PET/CT 与临床参数联合在预测新诊断多发性骨髓瘤(MM)患者中的作用。

方法

回顾性队列研究分析了 120 例接受 F-FDG PET/CT 扫描的 MM 患者。

结果

多因素分析显示,β2M、LDH、局灶性病变(FL)数量和 SUVmax 与 OS 显著相关。这 4 个变量用于构建一个新的分期系统(NSS),基于风险因素的数量。NSS 比国际分期系统(ISS)(P<.001 比 P=.086)更好地区分 III 期和 II 期的风险。对于 OS,DS 分期(Durie-Salmon 分期)的各个风险组之间无显著差异(P>.05)。基于 Spearman 相关分析,四肢骨骼病变、FL 数量和 SUVmax 的存在似乎表明 MM 处于晚期。ROC 曲线显示,β2M 与钙联合用于预测四肢骨骼病变的特异性为 96.3%,而 LDH 单独预测 FL 数量的特异性为 100%,尽管敏感性仅为 50%。

结论

F-FDG PET/CT 联合临床参数为新诊断 MM 患者的风险分层提供了一种准确而简单的方法。

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