Jing Yaoyao, Chen Yafang, Yu Yong, Zhao Haifeng, Yang Hongliang, Sun Bei, Wang Xiaofang
Department of Day Ward, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China.
J Cancer. 2023 Sep 4;14(14):2726-2738. doi: 10.7150/jca.87523. eCollection 2023.
To compare the diagnostic efficacy of PET-CT and bone marrow biopsy (BMB) in the detection of bone marrow involvement (BMI) in newly diagnosed patients with follicular lymphoma (FL), as well as their prognostic implications in such patients. Retrospective analysis was conducted on clinical data from 165 newly diagnosed FL patients. The benefits and drawbacks of PET-CT and BMB in assessing BMI in FL patients were compared and evaluated. Moreover, the prognostic outcomes and factors affecting the survival of FL patients were examined. Among 165 patients, bone marrow involvement (BMI) was diagnosed by PET-CT (PET) in 54 cases (32.7%), by bone marrow biopsy (BMB) in 50 cases (30.3%), and by either PET or BMB in 80 cases (48.5%). PET-CT scans upgraded 32 patients (19.4%) to stage IV, including 1 stage I and 4 stage II cases. Four patients were elevated to stage IV by BMB, all of whom had a previous stage III diagnosis. No patients with previous stages I or II were elevated to stage IV by BMB. The median follow-up time was 6.6 years (range,0-11.0 years). The 5-year OS was 86.7%, and the 5-year PFS was 44.8%. Multivariate analysis revealed that BMI by PET-CT was the only independent predictor of PFS reduction. Regarding OS, grade 3a and BMI by PET-CT were independent predictors of decreased survival. PET-CT enables a thorough evaluation of bone marrow involvement in patients with FL, and BMI identified by PET-CT can have substantially implications for patient prognosis. PET-CT obtains vital data for the diagnosis, treatment, and prognosis of FL patients. By contrast, BMB seldom augments crucial data.
比较正电子发射断层扫描-计算机断层扫描（PET-CT）和骨髓活检（BMB）在新诊断的滤泡性淋巴瘤（FL）患者中检测骨髓受累（BMI）的诊断效能，以及它们对此类患者的预后影响。对165例新诊断的FL患者的临床资料进行回顾性分析。比较和评估PET-CT和BMB在评估FL患者BMI方面的优缺点。此外，还研究了FL患者的预后结果及影响生存的因素。165例患者中，PET-CT诊断骨髓受累（BMI）54例（32.7%），骨髓活检诊断50例（30.3%），PET或BMB诊断80例（48.5%）。PET-CT扫描将32例患者（19.4%）分期提高至IV期，包括1例I期和4例II期患者。4例患者经BMB分期提高至IV期，所有这些患者之前均诊断为III期。没有I期或II期患者经BMB分期提高至IV期。中位随访时间为6.6年（范围0-11.0年）。5年总生存率（OS）为86.7%，5年无进展生存率（PFS）为44.8%。多因素分析显示，PET-CT检测的BMI是PFS降低的唯一独立预测因素。关于OS，3a级和PET-CT检测的BMI是生存降低的独立预测因素。PET-CT能够全面评估FL患者的骨髓受累情况，PET-CT确定的BMI对患者预后有重大影响。PET-CT可为FL患者的诊断、治疗和预后获取重要数据。相比之下，BMB很少增加关键数据。
