Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xi Cheng District, Beijing, 100050, China.
Ann Nucl Med. 2021 Mar;35(3):386-396. doi: 10.1007/s12149-021-01577-9. Epub 2021 Jan 19.
The purpose of this study was to investigate the prognosis predicting value of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) of F-FDG PET/CT, and clinical inflammatory cytokines in newly diagnosed secondary hemophagocytic lymphohistiocytosis (SHLH).
We retrospectively collected 58 patients with newly diagnosed SHLH from August 2016 to July 2019 in our hospital. All patients were followed up between 6 and 24 months. First, a comprehensive comparison of the general data between the death and the survival group was performed. Clinical lab indexes included were recorded and analyzed retrospectively. Second, the correlation between F-FDG PET/CT semiquantitative metabolic parameters of VAT, SAT and inflammatory cytokines was performed. 3D slicer software was used to get SUV and volume of VAT and SAT from F-FDG PET/CT. Third, overall survival (OS) analysis was performed. Finally, the prognosis predicting model was built based on risk factors to stratify SHLH patients.
There was significant difference in WBC, PLT, FBG, IL-10, PCR tests of EBV-DNA loads, SCD25 between the death group and the survival group. There was significant correlation between SAT coefficient variance (CV) and CRP, the mean standardized uptake value (SUVmean) of SAT (SAT SUVmean) and TG, SAT SUVmean and ESR. In univariate analysis with Cox regression analysis, SUVmean of VAT (VAT SUVmean), SAT Volume, SUVmean of SAT, CV of SAT (SAT HU CV), plasma EBV-DNA, WBC, PLT, FBG showed significance with OS. In multivariate Cox regression analysis, SAT Volume, SUVmean of SAT, plasma EBV-DNA, were independent prognostic factors for OS.
For newly diagnosed SHLH, SAT Volume, SUVmean of SAT, plasma EBV-DNA had significant relationship with poor prognosis. They were important independent predictors for overall survival for newly diagnosed SHLH.
本研究旨在探讨 F-FDG PET/CT 中内脏脂肪组织（VAT）和皮下脂肪组织（SAT）以及临床炎症细胞因子对新诊断的继发性噬血细胞性淋巴组织细胞增多症（SHLH）的预后预测价值。
我们回顾性收集了 2016 年 8 月至 2019 年 7 月我院收治的 58 例新诊断的 SHLH 患者，所有患者随访 6 至 24 个月。首先，对死亡组和存活组的一般资料进行全面比较，记录和回顾性分析临床实验室指标。其次，对 VAT 和 SAT 的 F-FDG PET/CT 半定量代谢参数与炎症细胞因子之间的相关性进行分析。使用 3D slicer 软件从 F-FDG PET/CT 中获得 VAT 和 SAT 的 SUV 和体积。然后进行总体生存（OS）分析。最后，基于风险因素构建 SHLH 患者的预后预测模型。
死亡组和存活组的白细胞计数（WBC）、血小板计数（PLT）、空腹血糖（FBG）、白细胞介素-10（IL-10）、EB 病毒（EBV）-DNA 拷贝数、可溶性 CD25（SCD25）检测结果存在显著差异。SAT 系数变异（CV）与 CRP、SAT 平均标准化摄取值（SAT SUVmean）与甘油三酯（TG）、SAT SUVmean 与红细胞沉降率（ESR）之间存在显著相关性。单因素 Cox 回归分析显示，VAT SUVmean、SAT 体积、SAT SUVmean、SAT CV、血浆 EBV-DNA、WBC、PLT、FBG 与 OS 有关。多因素 Cox 回归分析显示，SAT 体积、SAT SUVmean、血浆 EBV-DNA 是 OS 的独立预后因素。
对于新诊断的 SHLH，SAT 体积、SAT SUVmean、血浆 EBV-DNA 与不良预后有显著关系。它们是新诊断的 SHLH 总生存的重要独立预测因素。
