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初诊多发性骨髓瘤患者中基于F-FDG PET/CT的肿瘤代谢与精确细胞遗传学分层的比较

Comparison between tumour metabolism derived from F-FDG PET/CT and accurate cytogenetic stratification in newly diagnosed multiple myeloma patients.

作者信息

Silva Yannick, Riedinger Jean-Marc, Chrétien Marie-Lorraine, Caillot Denis, Corre Jill, Guillen Kévin, Cochet Alexandre, Tabouret-Viaud Claire, Loffroy Romaric

机构信息

Department of Nuclear Medicine, Unicancer-Georges François Leclerc Cancer Center, Dijon, France.

Department of Clinical Haematology, François-Mitterrand University Hospital, Dijon, France.

出版信息

Quant Imaging Med Surg. 2021 Oct;11(10):4299-4309. doi: 10.21037/qims-21-85.

Abstract

BACKGROUND

F-fluorodeoxyglucose positron emission tomography integrated with computed tomography (F-FDG PET/CT) is a useful tool for baseline staging in newly diagnosed multiple myeloma (MM) but also for prognostic stratification. This monocentric retrospective study aimed at examining the relation between baseline tumour metabolism assessed by F-FDG PET/CT and linear predictor (LP) score, a new cytogenetic stratification score.

METHODS

From March 2012 to March 2019, 57 patients with newly diagnosed MM addressed to our institution for baseline F-FDG PET/CT were included. LP score was determined on systematic iliac crest bone marrow samples. Obtained on CD138-sorted bone marrow plasma cells, this recent composite cytogenetic stratification is a 6-marker based weighted score using fluorescence in situ hybridization (FISH) ± single nucleotide polymorphism (SNP) arrays. We compared quantitative metabolic parameters and LP score using a Kruskal-Wallis test and visual suspicion of diffuse bone marrow involvement (DBI; based on hepatic background as threshold of positivity) and cytogenetic data using a Chi-squared test.

RESULTS

The distribution of total metabolic tumour volume (TMTV) and total lesion glycolysis (TLG) values among the three LP score categories was almost stochastic, with no significant association (P=0.70). Additionally, no significant association between TMTV/TLG and any of the six cytogenetic abnormalities included in LP score calculation. A significant association was found between visual high suspicion of DBI and LP score (P=0.036), and between this visual parameter and the presence of 1q gain (P=0.049).

CONCLUSIONS

There is no significant association between quantitative metabolic parameters assessed with F-FDG PET/CT and LP score in patients with newly diagnosed MM, suggesting a potential complementarity of these biomarkers for prognostic stratification. A significant association was found between high visual suspicion of DBI and LP score.

摘要

背景

氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描相结合(F-FDG PET/CT)是新诊断多发性骨髓瘤(MM)基线分期以及预后分层的有用工具。这项单中心回顾性研究旨在探讨F-FDG PET/CT评估的基线肿瘤代谢与线性预测因子(LP)评分(一种新的细胞遗传学分层评分)之间的关系。

方法

2012年3月至2019年3月,纳入57例因基线F-FDG PET/CT前来我院就诊的新诊断MM患者。LP评分通过系统性髂嵴骨髓样本确定。该最新的综合细胞遗传学分层是基于CD138分选的骨髓浆细胞,使用荧光原位杂交(FISH)±单核苷酸多态性(SNP)阵列的基于6个标志物的加权评分。我们使用Kruskal-Wallis检验比较定量代谢参数和LP评分,并使用卡方检验比较弥漫性骨髓受累(DBI;以肝脏本底作为阳性阈值)的视觉可疑情况和细胞遗传学数据。

结果

三个LP评分类别之间的总代谢肿瘤体积(TMTV)和总病变糖酵解(TLG)值分布几乎是随机的,无显著相关性(P = 0.70)。此外,TMTV/TLG与LP评分计算中包含的六个细胞遗传学异常中的任何一个之间均无显著相关性。DBI的高度视觉可疑与LP评分之间存在显著相关性(P = 0.036),并且该视觉参数与1q增益的存在之间也存在显著相关性(P = 0.049)。

结论

新诊断MM患者中,F-FDG PET/CT评估的定量代谢参数与LP评分之间无显著相关性,提示这些生物标志物在预后分层方面可能具有互补性。DBI的高度视觉可疑与LP评分之间存在显著相关性。

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