Peng P, Wu N, Tao X L, Liu Y, Lyu L, Cheng X
Department of Nuclear Medicine(PET-CT Center), National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2022 Apr 23;44(4):370-376. doi: 10.3760/cma.j.cn112152-20200525-00485.
To investigate the clinical value of pretreatment F-fluorodeoxy glucose positron emission tomography/computed tomography (F-FDG PET-CT) in extranodal NK/T-cell lymphoma. Eighty-one patients with pathologically confirmed extranodal NK/T-cell lymphoma and pretreatment with PET-CT scan in Cancer Hospital, Chinese Academy of Medical Sciences from August 2006 to December 2017 were enrolled in the study. The clinical, follow-up and imaging data were analyzed retrospectively. The relationship between maximum standard uptake value (SUV) and prognosis were evaluated by Mann-Whitney U test and Spearman rank correlation analysis. Among the 81 patients, 98.8% (80/81) were upper aerodigestive tract (UAT) involved. Lesions at extra-UAT sites were detected in 7 cases, involving parotid gland (=1), breast (=1), spleen (=1), pancreas (=1), skin and subcutaneous soft tissue (=1), muscle (=1), lung (=2) and bone (=3). Lymph node involvement were demonstrated in 33 cases. All of the lesions had increased uptake of PET, the median SUV was 8.6. PET-CT changed staging in 15 cases, and 12 cases were adjusted treatment methods. 21 cases were changed radiotherapy target because of PET-CT. The 1-, 2-year progression-free survival (PFS) rates were 88.7% and 80.3% while 1-, 2-year overall survival (OS) rates were 97.2% and 94.4% respectively. The median SUV of patients with local lymph nodes involvement was significantly higher than those without local lymph nodes involvement (=0.007). The SUV was positively associated with Ann Arbor stage (=0.366, =0.001), lactate dehydrogenase (=0.308, =0.005) and Ki-67 level (=0.270, =0.017). The SUV was inversely associated with lymphocyte count (=-0.324, =0.003) and hemoglobin content (=-0.225, =0.043). Extranodal NK/T-cell lymphoma predominantly occurs in extra-nodal organs, mainly in the upper respiratory and gastrointestinal tracts, with marked FDG-addiction. Compared with conventional imaging, F-FDG PET-CT is sensitive and comprehensive in detecting extra-nodal NK/T-cell lymphoma involvement, assisting in accurate clinical staging and treatment planning. Pretreatment SUV is potential for prognosis evaluation since it is correlated with prognostic factors.
探讨治疗前氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET-CT）在结外NK/T细胞淋巴瘤中的临床价值。纳入2006年8月至2017年12月在中国医学科学院肿瘤医院接受PET-CT扫描且经病理确诊为结外NK/T细胞淋巴瘤的81例患者。对其临床、随访及影像资料进行回顾性分析。采用Mann-Whitney U检验和Spearman等级相关分析评估最大标准摄取值（SUV）与预后的关系。81例患者中，98.8%（80/81）累及上呼吸消化道（UAT）。7例在UAT以外部位发现病变，包括腮腺（=1）、乳腺（=1）、脾脏（=1）、胰腺（=1）、皮肤及皮下软组织（=1）、肌肉（=1）、肺（=2）和骨（=3）。33例有淋巴结受累。所有病变PET摄取均增高，SUV中位数为8.6。PET-CT改变分期15例，调整治疗方案12例。21例因PET-CT改变放疗靶区。1年、2年无进展生存率（PFS）分别为88.7%和80.3%，1年、2年总生存率（OS）分别为97.2%和94.4%。局部淋巴结受累患者的SUV中位数显著高于无局部淋巴结受累患者（=0.007）。SUV与Ann Arbor分期（=0.366，=0.001）、乳酸脱氢酶（=0.308，=0.005）及Ki-67水平（=0.270，=0.017）呈正相关。SUV与淋巴细胞计数（=-0.324，=0.003）及血红蛋白含量（=-0.225，=0.043）呈负相关。结外NK/T细胞淋巴瘤主要发生于结外器官，以上呼吸消化道为主，具有明显的FDG摄取。与传统影像相比，F-FDG PET-CT在检测结外NK/T细胞淋巴瘤受累方面敏感且全面，有助于准确的临床分期和治疗规划。治疗前SUV与预后因素相关，具有预后评估潜力。
