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骨髓活检与PET-CT对霍奇金淋巴瘤和非霍奇金淋巴瘤患者骨髓受累情况的比较及对生存影响的评估

Comparison of Bone Marrow Involvement with Bone Marrow Biopsy and PET-CT and Evaluation of Any Effects on Survival in Patients Diagnosed with Hodgkin and Non-Hodgkin Lymphoma.

作者信息

Göçer Mesut, Kurtoğlu Erdal

机构信息

Division of Hematology, Department of Internal Medicine, Antalya Training and Research Hospital, 07100 Antalya, Turkey.

出版信息

Indian J Hematol Blood Transfus. 2021 Jan;37(1):52-59. doi: 10.1007/s12288-020-01284-x. Epub 2020 May 4.

Abstract

We aimed to demonstrate whether PET-CT can replace bone marrow biopsy in detecting bone marrow involvement in subtypes of lymphoma. In addition, we aimed to also reveal whether there is a difference between the mean survival of patients with bone marrow involvement via PET-CT or biopsy. A total of 276 newly diagnosed lymphoma patients who underwent bone marrow biopsy and PET-CT prior to the treatment were scanned retrospectively. Bone marrow biopsy was used as the standard method to investigate the presence of bone marrow involvement in PET-CT. The relationship between bone marrow involvement and mean survival was compared using both methods. Out of the 276 patients, bone marrow involvement was detected with PET-CT and with biopsy, respectively in 56 patients (20.2%) and in 78 patients (28.2%). In terms of PET-CT's accuracy with respect to revealing bone marrow involvement, the highest rates were achieved respectively in diffuse large B cell lymphoma (DLBCL) (87.4%) and Hodgkin lymphoma (HL) (77.7%). In both the PET-CT and bone marrow biopsy methods, Overall Survival (OS) was found to be significantly shorter in patients with involvement than in patients without involvement (: 0.001). PET-CT may replace bone marrow (BM) biopsy in detecting the bone marrow involvement in aggressive lymphoma subtypes such as DLBCL and HL. The presence of BM involvement at the time of diagnosis in both PET-CT and BM biopsy is associated with poor prognosis, and OS is short in this group.

摘要

我们旨在证明正电子发射断层扫描-计算机断层扫描(PET-CT)在检测淋巴瘤亚型的骨髓受累情况时是否可以替代骨髓活检。此外,我们还旨在揭示通过PET-CT或活检发现骨髓受累的患者的平均生存期是否存在差异。对276例在治疗前接受了骨髓活检和PET-CT检查的新诊断淋巴瘤患者进行了回顾性扫描。骨髓活检被用作研究PET-CT中骨髓受累情况的标准方法。使用这两种方法比较了骨髓受累与平均生存期之间的关系。在276例患者中,通过PET-CT和活检分别检测到56例(20.2%)和78例(28.2%)骨髓受累。就PET-CT揭示骨髓受累情况的准确性而言,在弥漫性大B细胞淋巴瘤(DLBCL)(87.4%)和霍奇金淋巴瘤(HL)(77.7%)中分别达到了最高率。在PET-CT和骨髓活检两种方法中,发现有受累的患者的总生存期(OS)明显短于无受累的患者(P = 0.001)。PET-CT在检测DLBCL和HL等侵袭性淋巴瘤亚型的骨髓受累情况时可能替代骨髓(BM)活检。PET-CT和BM活检诊断时存在BM受累均与预后不良相关,且该组患者的OS较短。

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