Gurion Ronit, Bernstine Hanna, Domachevsky Liran, Michelson Carmela, Raanani Pia, Vidal Liat, Shochat Tzippy, Gafter-Gvili Anat
Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah-Tikva, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Nuclear Medicine, Rabin Medical Center, Petah-Tikva, Israel.
Clin Lymphoma Myeloma Leuk. 2018 Oct;18(10):687-691. doi: 10.1016/j.clml.2018.06.022. Epub 2018 Jun 27.
Fluorine-18 fluorodeoxyglucose (FDG) avidity varies in peripheral T-cell lymphoma (PTCL). We evaluated FDG avidity of pretreatment positron emission tomography/computed tomography (P-PET/CT), to appraise the prognostic significance of interim PET/CT (I-PET/CT) and end of treatment PET/CT (E-PET/CT) in PTCL.
We performed a retrospective cohort study of patients with newly diagnosed or relapsed PTCL who had received any chemotherapy regimen from 2008 to 2015 in a tertiary center. P-PET/CT, I-PET/CT, and E-PET/CT studies were centrally reviewed. The primary outcomes were the prognostic role of I-PET/CT and E-PET/CT on progression-free survival (PFS) and overall survival (OS). The secondary outcomes were P-PET/CT avidity, the prognostic role of other baseline characteristics, and the correlation between the PET/CT and bone marrow biopsy findings.
We included 40 patients in the present analysis. The median OS and PFS for the whole cohort was 39 and 16 months, respectively. Of the 40 patients, 36 had positive P-PET/CT findings. A total of 23 patients underwent I-PET/CT, with positive findings for 10. Of the 40 patients, 34 underwent E-PET/CT, 26 of which had positive findings. The sensitivity, specificity, and negative predictive value of P-PET/CT for bone marrow involvement was 40%, 83%, and 89%, respectively. The factors significantly associated with PFS and OS on univariate analysis included elevated lactate dehydrogenase, and low lymphocyte, hemoglobin, and albumin levels. On multivariate analysis, only lymphopenia remained prognostic for PFS and OS. The E-PET/CT and I-PET/CT results were not prognostic for PFS or OS.
Our study has shown that 90% of PTCL cases will be FDG avid. However, PET/CT was not predictive for PFS or OS at any point. The only predictive factor was the presence of lymphopenia.
氟-18氟脱氧葡萄糖（FDG）摄取在周围T细胞淋巴瘤（PTCL）中存在差异。我们评估了预处理正电子发射断层扫描/计算机断层扫描（P-PET/CT）的FDG摄取情况，以评估中期PET/CT（I-PET/CT）和治疗结束时PET/CT（E-PET/CT）在PTCL中的预后意义。
我们对2008年至2015年在一家三级中心接受任何化疗方案的新诊断或复发PTCL患者进行了一项回顾性队列研究。对P-PET/CT、I-PET/CT和E-PET/CT检查结果进行集中审查。主要结局是I-PET/CT和E-PET/CT对无进展生存期（PFS）和总生存期（OS）的预后作用。次要结局是P-PET/CT摄取情况、其他基线特征的预后作用以及PET/CT与骨髓活检结果之间的相关性。
我们在本分析中纳入了40例患者。整个队列的中位OS和PFS分别为39个月和16个月。在这40例患者中，36例P-PET/CT检查结果为阳性。共有23例患者接受了I-PET/CT检查，其中10例检查结果为阳性。在这40例患者中，34例接受了E-PET/CT检查，其中26例检查结果为阳性。P-PET/CT对骨髓受累的敏感性、特异性和阴性预测值分别为40%、83%和89%。单因素分析中与PFS和OS显著相关的因素包括乳酸脱氢酶升高以及淋巴细胞、血红蛋白和白蛋白水平较低。多因素分析中，只有淋巴细胞减少对PFS和OS仍具有预后意义。E-PET/CT和I-PET/CT结果对PFS或OS无预后意义。
我们的研究表明，90%的PTCL病例会表现为FDG摄取。然而，PET/CT在任何时间点都不能预测PFS或OS。唯一的预测因素是存在淋巴细胞减少。
