Zhang Hanzhen, Xu Zihan, Zhou Wenlan, Chen Junjie, Wei Yongqiang, Wu Hubing, Wei Xiaolei, Feng Ru
Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, China.
PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Ann Hematol. 2024 Dec;103(12):5891-5902. doi: 10.1007/s00277-024-05717-9. Epub 2024 Sep 2.
Although several different parameters of PET/CT were reported to be predictive of survival in DLBCL, the best parameter remains to be elucidated and whether it could improve the risk stratification of IPI in patients with DLBCL.
262 DLBCL patients including in the training and validation cohort were retrospectively analyzed in this study.
Among different parameters, MTV was identified as the optimal prognostic parameter with a maximum area under the curve (AUC) of 0.652 ± 0.112 than TLG and SDmax (0.645 ± 0.113 and 0.600 ± 0.117, respectively). Patients with high MTV were associated with inferior PFS (p < 0.001 and p = 0.021, respectively) and OS (p < 0.001 and p < 0.001, respectively) in both the training and validation cohort. The multivariate analysis revealed that high MTV was an unfavorable factor for PFS (relative ratio [RR], 2.295; 95% confidence interval [CI], 1.457-3.615; p < 0.01) and OS (RR, 2.929; 95% CI 1.679-5.109; p < 0.01) independent of IPI.
Further analysis showed MTV could improve the risk stratification of IPI for both PFS and OS (p < 0.01 and p < 0.01, respectively). In conclusion, our study suggests that MTV was an optimal prognostic parameter of PET/CT for survival and it could improve the risk stratification of IPI in DLBCL, which may help to guide treatment in clinical trial.
尽管有报道称PET/CT的几个不同参数可预测弥漫性大B细胞淋巴瘤（DLBCL）的生存率，但最佳参数仍有待阐明，以及它是否能改善DLBCL患者国际预后指数（IPI）的风险分层。
本研究对纳入训练和验证队列的262例DLBCL患者进行了回顾性分析。
在不同参数中，代谢组织体积（MTV）被确定为最佳预后参数，其曲线下面积最大值（AUC）为0.652±0.112，优于总病变糖酵解（TLG）和最大标准化摄取值（SDmax）（分别为0.645±0.113和0.600±0.117）。在训练和验证队列中，MTV高的患者无进展生存期（PFS）较差（分别为p<0.001和p=0.021），总生存期（OS）也较差（分别为p<0.001和p<0.001）。多变量分析显示，独立于IPI，高MTV是PFS（相对比率[RR]，2.295；95%置信区间[CI]，1.457 - 3.615；p<0.01）和OS（RR，2.929；95% CI 1.679 - 5.109；p<0.01）的不利因素。
进一步分析表明，MTV可改善IPI对PFS和OS的风险分层（分别为p<0.01和p<0.01）。总之，我们的研究表明，MTV是PET/CT预测生存的最佳预后参数，它可以改善DLBCL中IPI的风险分层，这可能有助于指导临床试验中的治疗。
