CAJ | 학술논문

目的探讨18F-脱氧葡萄糖正电子发射计算机断层显像(FDG-PET)对淋巴瘤患者分期及预后评估的作用.方法对初诊的41例淋巴瘤患者,化疗前和化疗4个疗程后行FDG-PET,中位随访30个月,比较化疗前FDG-PET分期和化疗4个疗程后FDG-PET结果对预后的影响.结果 41例患者治疗前结内、外病灶的最大标准摄取值(SUVmax)分别为9.7±6.9和8.4±6.8.侵袭性非霍奇金淋巴瘤(NHL)和惰性NHL比较,结内、外病灶的SUVmax值差异有统计学意义(侵袭性NHL分别为10.3±7.5和9.1±6.5,惰性NHL分别为4.7±2.1和2.4±0.6,均P＜0.05).NHL和霍奇金淋巴瘤(HL)、B细胞和T细胞NHL、活化B与生发中心来源弥漫大B细胞淋巴瘤治疗前FDG-PET的SUVmax差异无统计学意义(P＞0.05).化疗前22例(54％)患者FDG-PET检出结外器官病变；6例(15％)因FDG-PET发现CT等其他检查未显示的淋巴结或结外病变而提高临床分期.治疗前经FDG-PET分期为Ⅰ、Ⅱ期的患者15例(37％),Ⅲ、Ⅳ期的患者26例(63％).随访期间,FDG-PET分期Ⅰ、Ⅱ期的患者中1例(7％)因疾病进展死亡,Ⅲ、Ⅳ期的患者中6例(23％)因疾病进展死亡.41例患者化疗4个疗程后行FDG-PET检查,FDG-PET阴性的患者17例(41％)中,随访期间1例(6％)因疾病复发死亡,FDG-PET阳性的患者24例(59％)中,随访期间6例(25％)因疾病进展死亡.结论化疗前FDG-PET检查有助于对淋巴瘤患者进行准确的临床分期,化疗4个疗程后FDG-PET检查有助于评估淋巴瘤患者的预后,指导进一步治疗.
목적 탐토18F-탈양포도당정전자발사계산궤단층현상(FDG-PET)대림파류환자분기급예후평고적작용.방법 대초진적41례림파류환자,화료전화화료4개료정후행FDG-PET,중위수방30개월,비교화료전FDG-PET분기화화료4개료정후FDG-PET결과대예후적영향.결과 41례환자치료전결내、외병조적최대표준섭취치(SUVmax)분별위9.7±6.9화8.4±6.8.침습성비곽기금림파류(NHL)화타성NHL비교,결내、외병조적SUVmax치차이유통계학의의(침습성NHL분별위10.3±7.5화9.1±6.5,타성NHL분별위4.7±2.1화2.4±0.6,균P＜0.05).NHL화곽기금림파류(HL)、B세포화T세포NHL、활화B여생발중심래원미만대B세포림파류치료전FDG-PET적SUVmax차이무통계학의의(P＞0.05).화료전22례(54％)환자FDG-PET검출결외기관병변；6례(15％)인FDG-PET발현CT등기타검사미현시적림파결혹결외병변이제고림상분기.치료전경FDG-PET분기위Ⅰ、Ⅱ기적환자15례(37％),Ⅲ、Ⅳ기적환자26례(63％).수방기간,FDG-PET분기Ⅰ、Ⅱ기적환자중1례(7％)인질병진전사망,Ⅲ、Ⅳ기적환자중6례(23％)인질병진전사망.41례환자화료4개료정후행FDG-PET검사,FDG-PET음성적환자17례(41％)중,수방기간1례(6％)인질병복발사망,FDG-PET양성적환자24례(59％)중,수방기간6례(25％)인질병진전사망.결론 화료전FDG-PET검사유조우대림파류환자진행준학적림상분기,화료4개료정후FDG-PET검사유조우평고림파류환자적예후,지도진일보치료.
Objective To evaluate the application of 18fluoro-deoxyglucose positron emission tomography (FDG-PET) to the staging and predicting outcome in patients with lymphoma.Methods 41 patients with newly diagnosed lymphoma (median age 57 years) were explored with FDG-PET prior to and after 4 cycles of chemotherapy.With a median follow-up of 30 months (range 10-68 months),the value of FDG-PET to staging and predicting clinical outcome was assessed. Results The maximum standardized uptake value (SUVmax) of nodal and extranodal lesions was 9.7±6.9 and 8.4±6.8 respectively prior to treatment.There were significant difference (P＜0.05) in aggressive non-Hodgkin's lymphoma and indolent non-Hodgkin's lymphoma,no significant difference (P＞0.05) in non-Hodgkin's lymphoma and Hodgkin's lymphoma (HL), B-cell neoplasms and T-cell neoplasms,germinal center B-cell-like DLBCL and activated B-cell-like DLBCL. In 41 patients, 22 patients (54 ％)were detected extranodal focus by FDG-PET before chemotherapy. FDG-PET imaging upstaged in 6(15％)of initial lymphoma patients.There were 15 patients (37 ％) in stage Ⅰ and Ⅱ and 26 patients(63 ％)in stage Ⅲ and Ⅳ by FDC-PET scan.1 patient (7 ％) in stage Ⅰ and Ⅱ,6 patient (23 ％) in stage Ⅲ and Ⅳ died of disease progression during follow-up.After 4 cycles of chemotherapy,the FDG-PET was negative in 41％(17/41),positive in 59 ％(24/41) respectively.1 patient(6 ％)died of disease relapse among 17 patients who were FDG-PET negative, 6 patient (25 ％)died of disease progression among 24 patients who were FDG-PET positive during follow-up. Conclusion FDG-PET scanning plays an important role in the pretreatment staging and prediction of the prognosis after 4 cycles of chemotherapy in patients with lymphoma.Thus it may offer the potential for change in treatment paradigms.