F-FDG PET/CT代谢参数与血管免疫母细胞性T细胞淋巴瘤预后关系的初步研究
A preliminary investigation of the relationship between F-FDG PET/CT metabolic parameters and prognosis in angioimmunoblastic T-cell lymphoma.
作者信息
Hu Lanping, Luo Nana, Li Lei, Qiu Dasheng, Hu Xiaoyan
机构信息
Department of Nuclear medicine, Hubei Cancer Hospital, The Seventh Clinical School Affiliated of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
出版信息
Front Oncol. 2023 Jun 15;13:1171048. doi: 10.3389/fonc.2023.1171048. eCollection 2023.
PURPOSE
The goal of the study was to determine the prognostic significance of metabolic parameters in baseline F-FDG PET/CT images obtained from patients with angioimmunoblastic T-cell lymphoma (AITL).
METHODS
Forty patients with pathologically diagnosed AITL who had baseline F-FDG PET/CT between May 2014 and May 2021 were assessed as part of this study. Maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), and total metabolic tumor volume (TMTV) were obtained and analyzed. In addition, many relevant features were evaluated, including sex, age, staging, International Prognostic Index (IPI), prediction index for T-cell lymphoma (PIT), Ki-67, and so on. Estimates of progression-free survival (PFS) and overall survival (OS) were determined using the log-rank test and Kaplan-Meier.
RESULTS
The median follow-up was 30.2 months (interquartile range 9.82-43.03). Throughout the follow-up period, 29 (72.5%) deaths occurred and 22 (55.0%) patients made progress. The rates for 2- and 3-year PFS were 43.6% and 26.4%, respectively. The 3- and 5-year OS were 42.6% and 21.5%. For TMTV, TLG, and SUVmax, the cut-off values were 87.0 cm3, 711.1, and 15.8, respectively. Poorer PFS and OS were substantially correlated with high SUVmax and TLG. An increased TMTV suggested a shorter OS. TLG performed independently as OS predictors in multivariate analysis. The risk score for predicting the prognosis of AITL includes the TMTV, TLG, SUVmax, and IPI scores, with 4.5 for TMTV, 2 for TLG, 1.5 for IPI scores, and 1 for SUVmax. Three risk categories of patients with AITL had 3-year OS rates of 100.0%, 43.3%, and 25.0%, respectively.
CONCLUSION
Baseline TLG was a strong predictor of OS. Here a new prognostic scoring system for AITL based on the clinical indicators and PET/CT metabolic parameters was constructed, which might make stratification of prognosis easy and also help to individualize treatment.
目的
本研究的目的是确定血管免疫母细胞性T细胞淋巴瘤（AITL）患者基线F-FDG PET/CT图像中代谢参数的预后意义。
方法
本研究评估了2014年5月至2021年5月期间40例经病理诊断为AITL且有基线F-FDG PET/CT的患者。获取并分析了最大标准化摄取值（SUVmax）、总病变糖酵解（TLG）和总代谢肿瘤体积（TMTV）。此外，还评估了许多相关特征，包括性别、年龄、分期、国际预后指数（IPI）、T细胞淋巴瘤预测指数（PIT）、Ki-67等。采用对数秩检验和Kaplan-Meier法确定无进展生存期（PFS）和总生存期（OS）的估计值。
结果
中位随访时间为30.2个月（四分位间距9.82-43.03）。在整个随访期间，发生29例（72.5%）死亡，22例（55.0%）患者出现疾病进展。2年和3年PFS率分别为43.6%和26.4%。3年和5年OS率分别为42.6%和21.5%。对于TMTV、TLG和SUVmax，临界值分别为87.0 cm³、711.1和15.8。较差的PFS和OS与高SUVmax和TLG显著相关。TMTV增加提示OS缩短。在多因素分析中，TLG独立作为OS的预测指标。预测AITL预后的风险评分包括TMTV、TLG、SUVmax和IPI评分，TMTV为4.5，TLG为2，IPI评分为1.5，SUVmax为1。AITL患者的三个风险类别3年OS率分别为100.0%、43.3%和25.0%。
结论
基线TLG是OS的有力预测指标。在此基于临床指标和PET/CT代谢参数构建了一种新的AITL预后评分系统，这可能使预后分层变得容易，也有助于治疗个体化。
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