经典型霍奇金淋巴瘤中 F-氟代脱氧葡萄糖正电子发射断层扫描半定量指标与坏死的关系。
Relationship between semiquantitative F-fluorodeoxyglucose positron emission tomography metrics and necrosis in classical Hodgkin lymphoma.
机构信息
Department of Hematology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
出版信息
Sci Rep. 2019 Jul 30;9(1):11073. doi: 10.1038/s41598-019-47453-5.
Semiquantitative F-fluoro-2-deoxy-D-glucose positron emission tomography (F-FDG PET) parameters have been proposed as prognostic markers in classical Hodgkin lymphoma (cHL). In non-Hodgkin lymphoma necrosis as assessed by F-FDG PET or computed tomography (CT) (necrosis) correlates with an adverse prognosis. We investigated whether semiquantitative F-FDG PET metrics correlate with necrosis, determined the incidence of necrosis and explored the prognostic impact of these factors in cHL. From 87 cHL cases treated with ABVD, (escalated) BEACOPP or CHOP chemotherapy between 2010 and 2017, 71 had both a NEDPAS/EARL accredited F-FDG PET and a contrast enhanced CT scan. Semiquantitative F-FDG PET parameters were determined using Hermes Hybrid 3D software. Necrosis, defined by photopenic tumor areas on F-FDG PET and attenuation values between 10 and 30 Hounsfield units (HUs) on CT, was assessed blinded to outcome. Univariate Cox regression survival analyses of progression free survival (PFS) were performed. Necrosis was observed in 18.3% of cHL patients. Bulky disease (tumor mass >10 cm in any direction) (P = 0.002) and TLG (P = 0.041) but no other semiquantitative parameters were significantly associated with necrosis. In exploratory univariate survival analysis for PFS the covariates IPS, bulky disease, MTV and TLG were prognostic, while necrosis was not.
半定量 F-氟代-2-脱氧-D-葡萄糖正电子发射断层扫描（F-FDG PET）参数已被提出作为经典霍奇金淋巴瘤（cHL）的预后标志物。在非霍奇金淋巴瘤中，通过 F-FDG PET 或计算机断层扫描（CT）评估的坏死（necrosis）与不良预后相关。我们研究了半定量 F-FDG PET 指标是否与坏死相关，确定了坏死的发生率，并探讨了这些因素在 cHL 中的预后影响。在 2010 年至 2017 年间，87 例接受 ABVD、（递增）BEACOPP 或 CHOP 化疗治疗的 cHL 患者中，有 71 例同时进行了 NEDPAS/EARL 认可的 F-FDG PET 和对比增强 CT 扫描。使用 Hermes Hybrid 3D 软件确定半定量 F-FDG PET 参数。通过 F-FDG PET 上的透光性肿瘤区域和 CT 上的 10 至 30 亨氏单位（HU）之间的衰减值定义坏死，评估结果为盲法。对无进展生存期（PFS）进行单变量 Cox 回归生存分析。18.3%的 cHL 患者观察到坏死。肿块性疾病（任何方向的肿瘤体积>10cm）（P=0.002）和 TLG（P=0.041），但其他半定量参数与坏死无显著相关性。在探索性的 PFS 单变量生存分析中，IPS、肿块性疾病、MTV 和 TLG 是预后因素，而坏死不是。
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