基线总体肿瘤糖酵解是否会提高 NCCN-IPI 在接受 R-CHOP 方案治疗的原发性胃弥漫大 B 细胞淋巴瘤患者中的预后价值？

Will Baseline Total Lesion Glycolysis Play a Role in Improving the Prognostic Value of the NCCN-IPI in Primary Gastric Diffuse Large B-Cell Lymphoma Patients Treated With the R-CHOP Regimen?

机构信息

From the Department of Nuclear Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School.

Department of Nuclear Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital.

出版信息

Clin Nucl Med. 2021 Jan;46(1):1-7. doi: 10.1097/RLU.0000000000003378.

DOI:10.1097/RLU.0000000000003378

PMID:33181743

Abstract

PURPOSE

The aim was to explore whether baseline total lesion glycolysis (TLG) can improve the prognostic value of the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in primary gastric diffuse large B-cell lymphoma (PG-DLBCL) patients treated with an R-CHOP-like regimen.

MATERIALS AND METHODS

Ninety-four PG-DLBCL patients who underwent baseline PET/CT between July 2010 and May 2019 were included in this retrospective study. FDG-avid lesions in each patient were segmented to calculate the SUVmax, total metabolic tumor volume (TMTV), and TLG. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate prognosis.

RESULTS

During the follow-up period of 5 to 108 months (35.3 ± 23.5 months), high TLG and a high NCCN-IPI were significantly associated with poor PFS and OS. Total lesion glycolysis and the NCCN-IPI were independent predictors of PFS and OS. Patients were stratified into 3 groups according to the combination of TLG and the NCCN-IPI for PFS (P < 0.001) and OS (P < 0.001): high-risk group (TLG > 1159.1 and NCCN-IPI 4-8) (PFS and OS, 57.7% and 61.5%, respectively, n = 42), intermediate-risk group (TLG > 1159.1 or NCCN-IPI 4-8) (PFS and OS, both 76.9%, n = 26), and low-risk group (TLG ≤ 1159.1 and NCCN-IPI 0-3) (PFS and OS, 97.6% and 100.0%, respectively, n = 26).

CONCLUSIONS

Both TLG and the NCCN-IPI are independent predictors of PG-DLBCL patient survival. Moreover, the combination of TLG and the NCCN-IPI improved patient risk stratification and might help personalize therapeutic regimens.

摘要

目的

本研究旨在探讨基线总病变糖酵解（TLG）是否可以提高接受 R-CHOP 样方案治疗的原发性胃弥漫性大 B 细胞淋巴瘤（PG-DLBCL）患者的国家综合癌症网络国际预后指数（NCCN-IPI）的预后价值。

材料与方法

本回顾性研究纳入了 2010 年 7 月至 2019 年 5 月期间进行基线 PET/CT 的 94 例 PG-DLBCL 患者。对每位患者的 FDG 摄取病灶进行分割，以计算 SUVmax、总代谢肿瘤体积（TMTV）和 TLG。无进展生存期（PFS）和总生存期（OS）被用作评估预后的终点。

结果

在 5 至 108 个月的随访期间（35.3±23.5 个月），高 TLG 和高 NCCN-IPI 与较差的 PFS 和 OS 显著相关。TLG 和 NCCN-IPI 是 PFS 和 OS 的独立预测因素。根据 TLG 和 NCCN-IPI 的组合，患者被分为 3 组进行 PFS（P<0.001）和 OS（P<0.001）分层：高危组（TLG>1159.1 和 NCCN-IPI 4-8）（PFS 和 OS 分别为 57.7%和 61.5%，n=42），中危组（TLG>1159.1 或 NCCN-IPI 4-8）（PFS 和 OS 均为 76.9%，n=26）和低危组（TLG≤1159.1 和 NCCN-IPI 0-3）（PFS 和 OS 分别为 97.6%和 100.0%，n=26）。