PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106 Zhongshan Er Road, Guangzhou, 510080, China.
Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangzhou, China.
Ann Hematol. 2023 Oct;102(10):2779-2789. doi: 10.1007/s00277-023-05379-z. Epub 2023 Aug 2.
This study aimed to clarify the clinical and prognostic role of body composition and metabolic parameters extracted from baseline F-FDG PET/CT in patients with diffuse large B-cell lymphoma (DLBCL). We retrospectively collected the clinicopathological and F-FDG PET/CT parameters of 181 DLBCL patients. The indexes of skeletal muscle, subcutaneous adipose tissue, and visceral adipose tissue were calculated using the area measured at the 3 lumbar level normalized for height. Additionally, the metabolic activity of corresponding muscle and adipose tissue, and maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of all lesions were measured. Survival endpoints included progression-free survival (PFS) and overall survival (OS). We identified 75 (41.4%) patients with low skeletal muscle index (sarcopenia), presenting risk factors including male, high β-microglobulin, low BMI, high visceral adipose tissue index, low SUVmax of skeletal muscle, and high SUVmax of visceral adipose tissue. Male, low BMI, low visceral adipose tissue index, and high SUVmax of subcutaneous adipose tissue were risk factors for low subcutaneous adipose tissue index diagnosed in 105 (58.0%) patients. In total, 132 (79.2%) patients represented low visceral adipose tissue index, associated with younger age, B symptoms, and low BMI. Eastern Cooperative Oncology Group (ECOG) status, sarcopenia, and visceral adipose tissue index were found independently predictive of PFS and OS, while β-microglobulin was independently predictive of OS. In conclusion, body composition indexes were correlated with both clinical characteristics and F-FDG PET/CT metabolic parameters, significantly impacting survival, such that sarcopenia and high visceral adipose tissue index were powerful predictors of poor DLBCL outcomes.
本研究旨在阐明基线 F-FDG PET/CT 提取的人体成分和代谢参数在弥漫性大 B 细胞淋巴瘤（DLBCL）患者中的临床和预后作用。我们回顾性收集了 181 例 DLBCL 患者的临床病理和 F-FDG PET/CT 参数。使用第 3 腰椎水平的面积除以身高来计算骨骼肌、皮下脂肪组织和内脏脂肪组织的指标。此外，还测量了相应肌肉和脂肪组织的代谢活性以及所有病变的最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG）。生存终点包括无进展生存期（PFS）和总生存期（OS）。我们发现 75 例（41.4%）患者存在骨骼肌指数低（肌肉减少症），其危险因素包括男性、β-微球蛋白高、BMI 低、内脏脂肪组织指数高、骨骼肌 SUVmax 低和内脏脂肪组织 SUVmax 高。男性、BMI 低、内脏脂肪组织指数低和皮下脂肪组织 SUVmax 高是 105 例（58.0%）患者中皮下脂肪组织指数低的危险因素。共有 132 例（79.2%）患者表现为低内脏脂肪组织指数，与年龄较小、B 症状和 BMI 低有关。ECOG 状态、肌肉减少症和内脏脂肪组织指数是 PFS 和 OS 的独立预测因素，而β-微球蛋白是 OS 的独立预测因素。总之，人体成分指标与临床特征和 F-FDG PET/CT 代谢参数相关，显著影响生存，因此肌肉减少症和高内脏脂肪组织指数是 DLBCL 不良预后的有力预测因素。
