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[正电子发射断层显像/计算机断层扫描(PET/CT)、骨髓活检及骨髓穿刺术在检测弥漫性大B细胞淋巴瘤骨髓受累中的应用及预后价值]

[Utility and prognostic value of PET/CT, bone marrow biopsy and aspirate for detection of bone marrow involvement in diffuse large B-cell lymphoma].

作者信息

Jiang X Y, Zou D M, Zhang Y Q, Wang Z, Zhang W, Zhou D B, Zhang Y

机构信息

Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2022 Aug 14;43(8):663-667. doi: 10.3760/cma.j.issn.0253-2727.2022.08.008.

Abstract

This study aimed to determine the value of bone marrow biopsy (BMB) , bone marrow aspiration (BMA) , and positron emission tomography combined with computed tomography (PET/CT) in bone marrow (BM) involvement and prognosis evaluation in diffuse large B-cell lymphoma (DLBCL) . The clinical data of patients with DLBCL who underwent PET/CT, BMB, and BMA of the iliac crest were retrospectively analyzed in Peking Union Medical College Hospital from January 2015 to November 2017. The BM involvement on PET/CT was defined as the ratio of maximal standardized uptake values of iliac crest BM to liver parenchyma intensity ≥1. A total of 76 patients without liver involvement were enrolled, there were 32 males, and the median age was 53 (17-79) . Moreover, 16 patients (21.1%) had BM involvement on PET/CT, 12 (15.8%) had positive BMB, and 13 (17.1%) had positive BMA. Excellent correlation between BMA and BMB (=0.943) was found, including good correlation between PET/CT and BMB/BMA (=0.763 and 0.776, respectively) . After a median follow-up of 52 (0-82) months, BM involvement by BMB (=0.037) and BMA (=0.007) were poor prognostic factors for overall survival, positive PET/CT had no significant effect on prognosis (>0.05) . PET/CT, BMB, and BMA are effective methods to detect BM involvement with great concordance. However, iliac crest BMB and BMA showed superior performance in prognosis evaluation.

摘要

本研究旨在确定骨髓活检(BMB)、骨髓穿刺(BMA)以及正电子发射断层扫描联合计算机断层扫描(PET/CT)在弥漫性大B细胞淋巴瘤(DLBCL)骨髓受累及预后评估中的价值。回顾性分析了2015年1月至2017年11月在北京协和医院接受髂嵴PET/CT、BMB及BMA检查的DLBCL患者的临床资料。PET/CT上的骨髓受累定义为髂嵴骨髓最大标准化摄取值与肝实质强度之比≥1。共纳入76例无肝脏受累的患者,其中男性32例,中位年龄为53岁(17 - 79岁)。此外,16例(21.1%)患者在PET/CT上有骨髓受累,12例(15.8%)BMB阳性,13例(17.1%)BMA阳性。发现BMA与BMB之间具有良好的相关性(=0.943),PET/CT与BMB/BMA之间也具有良好的相关性(分别为=0.763和0.776)。中位随访52个月(0 - 82个月)后,BMB(=0.037)及BMA(=0.007)提示的骨髓受累是总生存的不良预后因素,PET/CT阳性对预后无显著影响(>0.05)。PET/CT、BMB及BMA是检测骨髓受累的有效方法,一致性良好。然而,髂嵴BMB和BMA在预后评估中表现更优。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4b5/9593017/183098efa71a/cjh-43-08-663-g001.jpg

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