Cengiz Arzu, Arda Hayri Üstün, Döğer Firuzan, Yavaşoğlu İrfan, Yürekli Yakup, Bolaman Ali Zahit
Adnan Menderes University Faculty of Medicine, Department of Nuclear Medicine, Aydın, Turkey
Adnan Menderes University Faculty of Medicine, Department of Internal Medicine, Aydın, Turkey
Turk J Haematol. 2018 Aug 3;35(3):175-180. doi: 10.4274/tjh.2017.0372. Epub 2018 May 28.
The aim of this study was to evaluate the relation between the rate of fluorine-18 (18F) fludeoxyglucose (FDG) uptake and CD38 and CD138 expression in myeloma cells in bone marrow and other clinical parameters in patients with multiple myeloma (MM).
Patients with the diagnosis of MM who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) for initial staging were evaluated retrospectively. We analyzed a total of 42 patients (43-83 years old, mean: 64.4±9.9). Hematological and biochemical tests including hemoglobin, hematocrit, C-reactive protein, β2-microglobulin, creatinine, albumin, calcium, lactate dehydrogenase, and erythrocyte sedimentation rate were recorded. In bone marrow samples, plasma cell ratio and CD38 and CD138 immunohistochemical staining were evaluated. On PET/CT images, mean standardized uptake values (SUV) of the right anterior and posterior iliac crest and right proximal femora were calculated. The correlations between the average SUV of bone marrow and CD38- and CD138-expressing myeloma cells and other parameters were analyzed by Spearman’s correlation test. Values of p<0.05 were considered statistically significant.
Types of MM were IgGK (45%), IgGL (21%), IgA (7%), IgA (10%), and others (17%). Thirty-two (76%) patients were at stage III according to the Salmon-Durie staging system. There was a statistically significant positive correlation between bone marrow FDG uptake and percentage of plasma cells in bone marrow and CD38 and CD138 expression in plasma cells (r=0.403, r=0.339, and r=0.409) and β2-microglobulin and C-reactive protein levels (r=0.676, r=0.541). There was a negative correlation between bone marrow FDG uptake and hemoglobin and hematocrit values (r=-0.377 and r=-0.368). Other hematological parameters were not correlated with FDG uptake in bone marrow.
Increased FDG uptake is correlated with the percentage of CD38 and CD138 expression in plasma cells in bone marrow. In addition to initial staging, 18F-FDG PET/CT is useful in treatment planning and prognostic evaluation in MM patients.
本研究旨在评估多发性骨髓瘤（MM）患者骨髓中氟-18（18F）氟脱氧葡萄糖（FDG）摄取率与骨髓瘤细胞中CD38和CD138表达以及其他临床参数之间的关系。
对因初始分期接受18F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）的MM诊断患者进行回顾性评估。我们共分析了42例患者（年龄43 - 83岁，平均：64.4±9.9岁）。记录了包括血红蛋白、血细胞比容、C反应蛋白、β2微球蛋白、肌酐、白蛋白、钙、乳酸脱氢酶和红细胞沉降率在内的血液学和生化检查结果。在骨髓样本中，评估浆细胞比例以及CD38和CD138免疫组化染色情况。在PET/CT图像上，计算右髂前和后嵴以及右股骨近端的平均标准化摄取值（SUV）。通过Spearman相关性检验分析骨髓平均SUV与表达CD38和CD138的骨髓瘤细胞以及其他参数之间的相关性。p<0.05的值被认为具有统计学意义。
MM类型为IgGK（45%）、IgGL（21%）、IgA（7%）、IgA（10%）和其他（17%）。根据Salmon-Durie分期系统，32例（76%）患者处于III期。骨髓FDG摄取与骨髓中浆细胞百分比以及浆细胞中CD38和CD138表达（r = 0.403、r = 0.339和r = 0.409）以及β2微球蛋白和C反应蛋白水平（r = 0.676、r = 0.541）之间存在统计学显著正相关。骨髓FDG摄取与血红蛋白和血细胞比容值之间存在负相关（r = -0.377和r = -0.368）。其他血液学参数与骨髓FDG摄取无关。
FDG摄取增加与骨髓中浆细胞CD38和CD138表达百分比相关。除初始分期外，18F-FDG PET/CT在MM患者的治疗计划和预后评估中也有用。
