Liu Fei, Gu Bingxin, Li Nan, Pan Herong, Chen Wen, Qiao Ying, Song Shaoli, Liu Xiaosheng
Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Front Oncol. 2022 Apr 14;12:862473. doi: 10.3389/fonc.2022.862473. eCollection 2022.
Mantle cell lymphoma (MCL) represents a group of highly heterogeneous tumors, leading to a poor prognosis. Early prognosis prediction may guide the choice of therapeutic regimen. Thus, the purpose of this study was to investigate the potential application value of heterogeneity index (HI) in predicting the prognosis of MCL.
A total of 83 patients with histologically proven MCL who underwent baseline fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) were retrospectively enrolled. The clinicopathologic index and PET/CT metabolic parameters containing maximum and mean standard uptake value (SUV and SUV), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and HI were evaluated. Receiver operating characteristic (ROC) curve analyses were performed to determine the optimal cutoff values of the parameters for progression-free survival (PFS) and overall survival (OS). Univariate and multivariate Cox regression were used to assess relationships between risk factors and recurrence. Kaplan-Meier plots were applied for survival analyses.
In univariate analyses, age [HR = 2.51, 95% CI = 1.20-5.24, = 0.041 for body weight (BW)] and HI-BW (HR = 4.17, 95% CI = 1.00-17.38, = 0.050) were significantly correlated with PFS. In multivariate analyses, age (HR = 2.61, 95% CI = 1.25-5.47, = 0.011 for BW) and HI-BW (HR = 4.41, 95% CI = 1.06-18.41, = 0.042) were independent predictors for PFS, but not for OS. B symptoms (HR = 5.00, 95% CI = 1.16-21.65, = 0.031 for BW) were an independent prognostic factor for OS, but not for PFS. The other clinicopathologic index and PET/CT metabolic parameters were not related to outcome survival in MCL.
The age and HI derived from baseline PET/CT parameters were significantly correlated with PFS in MCL patients.
套细胞淋巴瘤（MCL）是一组高度异质性的肿瘤，预后较差。早期预后预测可指导治疗方案的选择。因此，本研究旨在探讨异质性指数（HI）在预测MCL预后中的潜在应用价值。
回顾性纳入83例经组织学证实的MCL患者，这些患者均接受了基线氟-18-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）检查。评估临床病理指标以及PET/CT代谢参数，包括最大和平均标准摄取值（SUVmax和SUVmean）、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和HI。进行受试者操作特征（ROC）曲线分析，以确定无进展生存期（PFS）和总生存期（OS）参数的最佳截断值。采用单因素和多因素Cox回归分析评估危险因素与复发之间的关系。应用Kaplan-Meier生存曲线进行生存分析。
在单因素分析中，年龄[HR = 2.51，95%CI = 1.20 - 5.24，P = 0.041（体重相关）]和HI-BW（HR = 4.17，95%CI = 1.00 - 17.38，P = 0.050）与PFS显著相关。在多因素分析中，年龄（HR = 2.61，95%CI = 1.25 - 5.47，P = 0.011（体重相关））和HI-BW（HR = 4.41，95%CI = 1.06 - 18.41，P = 0.042）是PFS的独立预测因素，但不是OS的独立预测因素。B症状（HR = 5.00，95%CI = 1.16 -
