Oner Ali Ozan, Özdemir Çiğdem, Yavaşoğlu Filiz, Şenol Yiğit, Adsız Sena Naz
Department of Nuclear Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Department of Pathology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
Rev Esp Med Nucl Imagen Mol (Engl Ed). 2023 Sep-Oct;42(5):289-295. doi: 10.1016/j.remnie.2023.03.002. Epub 2023 Mar 22.
The aim of this study was to determine the power of the SUVmax value obtained from F-FDG PET/CT in multiple myeloma (MM) patients to be able to predict immunophenotype characteristics (CD20, CD44, CD56, CD117, CD138 antigen expressions), bone marrow fibrosis, cyclin D1 oncogene, and M-protein subtypes which play a role in diagnosis-treatment and prognosis of the disease.
The study included 54 patients with multiple myeloma who underwent PET/CT for initial staging and bone marrow biopsy. The relationship was examined in these patients between the SUVmax value measured from the iliac bone region and the immunohistochemical and bone marrow fibrosis data of the biopsy taken from the iliac bone. The Mann Whitney U test was used in the comparisons of dependent paired groups, and the Kruskal Wallis H test in the comparisons of three or more groups.
The median SUVmax value was 4.5 (1.9-15.6) in patients with CD117 antigen positivity, which was statistically significantly higher than the value in the patients with CD117 negativity (p = 0.031). When patient grouping was made according to the reticulin level; we found that the median SUVmax value was 4.9 (3.0-14.8) in the group with increased fibrosis and 3.6 (1.6-15.6) in the group with low fibrosis. The median SUVmax was statistically significantly higher in the group with increased fibrosis compared to the group with low fibrosis (p = 0.004). No statistically significant difference was determined in the comparisons of the SUVmax values when the patients were grouped according to the immunoglobulin heavy chain and light chain, CD20, CD44, CD56, and cyclin D1 characteristics (p > 0.05).
In MM patients who underwent PET/CT for initial staging, significant relationships were determined between FDG uptake in the bone marrow (SUVmax) and CD117 antigen and bone marrow fibrosis, which is an important prognostic factor. Higher SUVmax values were determined in the bone marrow of patients with increased fibrosis and CD117 positivity.
本研究旨在确定从F-FDG PET/CT获得的SUVmax值在多发性骨髓瘤（MM）患者中预测免疫表型特征（CD20、CD44、CD56、CD117、CD138抗原表达）、骨髓纤维化、细胞周期蛋白D1癌基因和M蛋白亚型的能力，这些因素在该疾病的诊断、治疗和预后中发挥作用。
本研究纳入了54例接受PET/CT进行初始分期和骨髓活检的多发性骨髓瘤患者。在这些患者中，检查了从髂骨区域测量的SUVmax值与从髂骨获取的活检组织的免疫组织化学和骨髓纤维化数据之间的关系。在相关配对组的比较中使用曼-惠特尼U检验，在三组或更多组的比较中使用克鲁斯卡尔-沃利斯H检验。
CD117抗原阳性患者的SUVmax值中位数为4.5（1.9-15.6），在统计学上显著高于CD117阴性患者的值（p = 0.031）。当根据网硬蛋白水平对患者进行分组时；我们发现纤维化增加组的SUVmax值中位数为4.9（3.0-14.8），低纤维化组为3.6（1.6-15.6）。与低纤维化组相比，纤维化增加组的SUVmax中位数在统计学上显著更高（p = 0.004）。当根据免疫球蛋白重链和轻链、CD20、CD44、CD56和细胞周期蛋白D1特征对患者进行分组时，SUVmax值的比较未发现统计学上的显著差异（p>0.05）。
在接受PET/CT进行初始分期的MM患者中，确定了骨髓中的FDG摄取（SUVmax）与CD117抗原和骨髓纤维化之间存在显著关系，骨髓纤维化是一个重要的预后因素。在纤维化增加和CD117阳性的患者骨髓中确定了更高的SUVmax值。
