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F-FDG PET/CT 检查所得基线身体成分参数对血管免疫母细胞性 T 细胞淋巴瘤患者的预后价值

Prognostic value of baseline body composition parameters from F-FDG PET/CT in angioimmunoblastic T-cell lymphoma patients.

作者信息

Gong Huanyu, Shang Jingjie, Li Jianyong, Ding Chongyang, Xu Hao, Tang Lijun, Cheng Yong

机构信息

Department of Nuclear Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.

Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Ann Hematol. 2025 Aug 23. doi: 10.1007/s00277-025-06562-0.

Abstract

This retrospective study investigated preliminarily the prognostic value of body composition parameters derived from baseline F-FDG PET/CT in angioimmunoblastic T-cell lymphoma (AITL) patients. We included 94 treatment-naïve AITL patients diagnosed by histopathology. Based on the axial CT images of the third lumbar vertebra, the areas of skeletal muscle (SM), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were semi-automatically delineated and standardized to finally obtain SM index (SMI), VAT index (VATI), and SAT index (SATI). Body composition density characterized by CT attenuation was obtained, including SM density (SMD), VAT density (VATD), and SAT density (SATD). Besides, the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) were also calculated. Endpoints included progression-free survival (PFS) and overall survival (OS). Survival curves and Cox regression analysis were performed‌‌.Of 94 AITL patients(mean age:63.4 ± 9.7 years,67% men), 65 progressed and 55 died[median follow-up: 27.5 (10.5-45.7) months].High baseline C-reactive protein level [hazard ratio (HR) = 2.47, 95%CI: 1.37-4.45, p = 0.003), low SMD (HR = 2.18, 95%CI:1.29-3.69, p = 0.003), high SATD (HR = 1.92, 95%CI: 1.05-3.54, p = 0.035), and low VATI (HR = 1.95, 95%CI: 1.12-3.38, p = 0.018) were independent risk factors for poor PFS. AITL score>2(HR = 2.90, 95%CI: 1.59-5.29, p < 0.001), sarcopenia(HR = 1.78, 95%CI: 1.01-3.12,p = 0.045), low VATI(HR = 2.24,95%CI: 1.27-3.95,p = 0.005), and high TMTV(HR = 2.46, 95%CI: 1.37-4.40, p = 0.003) may serve as independent risk factors for poor OS. In conclusion, in addition to conventional TMTV, body composition parameters derived from baseline F-FDG PET/CT may offer preliminary prognostic value for AITL patients.

摘要

这项回顾性研究初步探讨了基线F-FDG PET/CT得出的身体成分参数在血管免疫母细胞性T细胞淋巴瘤(AITL)患者中的预后价值。我们纳入了94例经组织病理学确诊的初治AITL患者。基于第三腰椎的轴向CT图像,半自动勾勒出骨骼肌(SM)、内脏脂肪组织(VAT)和皮下脂肪组织(SAT)的面积并进行标准化,最终得出SM指数(SMI)、VAT指数(VATI)和SAT指数(SATI)。获取以CT衰减为特征的身体成分密度,包括SM密度(SMD)、VAT密度(VATD)和SAT密度(SATD)。此外,还计算了最大标准化摄取值(SUVmax)、总代谢肿瘤体积(TMTV)和总病变糖酵解(TLG)。观察终点包括无进展生存期(PFS)和总生存期(OS)。进行了生存曲线和Cox回归分析。在94例AITL患者中(平均年龄:63.4±9.7岁,67%为男性),65例病情进展,55例死亡[中位随访时间:27.5(10.5 - 45.7)个月]。高基线C反应蛋白水平[风险比(HR)=2.47,95%置信区间:1.37 - 4.45,p = 0.003]、低SMD(HR = 2.18,95%置信区间:1.29 - 3.69,p = 0.003)、高SATD(HR = 1.92,95%置信区间:1.05 - 3.54,p = 0.035)和低VATI(HR = 1.95,95%置信区间:1.12 - 3.38,p = 0.018)是PFS不良的独立危险因素。AITL评分>2(HR = 2.90,95%置信区间:1.59 - 5.29,p < 0.001)、肌肉减少症(HR = 1.78,95%置信区间:1.01 - 3.12,p = 0.045).低VATI(HR = 2.24,95%置信区间:1.27 - 3.95,p = 0.005)和高TMTV(HR = 2.46,95%置信区间:1.37 - 4.40,p = 0.003)可能是OS不良的独立危险因素。总之,除了传统的TMTV外,基线F-FDG PET/CT得出的身体成分参数可能为AITL患者提供初步的预后价值

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