Nogami Kyoko, Nishikawa Yotaro, Mochida Kosuke, Terada Tamasa, Azuma Minako, Nakai Michikazu, Amano Masahiro
Department of Dermatology, University of Faculty Miyazaki of Medicine, Miyazaki, Japan.
Department of Radiology, University of Faculty Miyazaki of Medicine, Miyazaki, Japan.
J Dermatol. 2025 Aug 6. doi: 10.1111/1346-8138.17867.
The prognostic utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in adult T-cell leukemia/lymphoma (ATLL) remains unclear, particularly in patients with indolent subtypes and cutaneous involvement. This study aimed to evaluate the usefulness of FDG-PET in predicting clinical outcomes in patients with indolent ATLL presenting with skin lesions. We retrospectively reviewed indolent ATLL with cutaneous involvement who underwent F-fluorodeoxyglucose positron emission tomography at our institute for initial disease staging between April 2007 and March 2022. The data obtained were compared with the findings of cutaneous involvement in ATLL. The effect of maximum standardized uptake value on progression-free survival was analyzed using the Kaplan-Meier method. Patients were divided into groups based on whether their maximum standardized uptake value was above or below the overall mean maximum standardized uptake value (2.18), and progression-free survival was compared between the groups. Forty-three patients with indolent ATLL were included. We divided the cutaneous involvement of ATLL into six subtypes according to a previously reported classification of eruption types: patch, plaque, multipapular, nodulotumoral, erythrodermic, and purpuric. A total of 18 of 43 patients (41.9%) had F-fluorodeoxyglucose-positive cutaneous lesions. However, 25 patients showed no F-fluorodeoxyglucose uptake in cutaneous lesions. There was a significant difference in the mean maximum standardized uptake value between the nodulotumoral and multipapular (p = 0.036), nodulotumoral and patch (p = 0.036). There was a statistically significant difference in progression-free survival between the maximum standardized uptake value ≥ 2.18 and < 2.18 groups (p = 0.020). These findings indicate that the maximum standardized uptake value in cutaneous lesions could determine the prognostic association of ATLL with cutaneous lesions. Careful follow-up is required for patients with a higher maximum standardized uptake value for cutaneous lesions.
18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在成人T细胞白血病/淋巴瘤（ATLL）中的预后价值仍不明确，尤其是在惰性亚型和皮肤受累的患者中。本研究旨在评估FDG-PET在预测表现为皮肤病变的惰性ATLL患者临床结局中的作用。我们回顾性分析了2007年4月至2022年3月期间在我院接受F-氟脱氧葡萄糖正电子发射断层扫描进行初始疾病分期的皮肤受累惰性ATLL患者。将获得的数据与ATLL皮肤受累的结果进行比较。采用Kaplan-Meier法分析最大标准化摄取值对无进展生存期的影响。根据最大标准化摄取值高于或低于总体平均最大标准化摄取值（2.18）将患者分组，并比较两组之间的无进展生存期。纳入了43例惰性ATLL患者。根据先前报道的皮疹类型分类，我们将ATLL的皮肤受累分为六种亚型：斑片、斑块、多丘疹、结节肿瘤、红皮病和紫癜。43例患者中有18例（41.9%）有F-氟脱氧葡萄糖阳性皮肤病变。然而，25例患者的皮肤病变未显示F-氟脱氧葡萄糖摄取。结节肿瘤型与多丘疹型（p = 0.036）、结节肿瘤型与斑片型（p = 0.036）之间的平均最大标准化摄取值存在显著差异。最大标准化摄取值≥2.18组和<2.18组之间的无进展生存期存在统计学显著差异（p = 0.020）。这些结果表明，皮肤病变中的最大标准化摄取值可以确定ATLL与皮肤病变的预后关联。对于皮肤病变最大标准化摄取值较高的患者，需要进行密切随访。
