CAJ | 학술논문

目的：探讨弥漫大B细胞淋巴瘤（DLBCL）患者在化疗中期和中后期进行18F-FDG PET/CT显像判断预后的价值差异。方法 DLBCL初诊患者142例，于标准化疗第3~4个疗程结束进行首次18F-FDG PET/CT评价为化疗中期组，于标准化疗5~8个疗程结束进行首次PET/CT评价者为化疗中后期组，两组各有71例，首次PET/CT显像结果记录为阴性和阳性。所有患者随访18~114个月（平均28.73个月），根据随访结果计算无进展生存时间（PFS）和无进展生存率（PFS%），比较化疗中期组与中后期组患者首次18F-FDG PET/CT显像结果与预后的关系。结果化疗中期组18F-FDG PET/CT显像阴性和阳性率分别为63.4%、36.6%，化疗中后期组PET/CT显像阴性和阳性率分别为66.2%、33.8%，两组PET/CT显像阴性率及阳性率无明显差异（χ2=12.423，P>0.05）。PFS比较，化疗中期组首次18F-FDG PET/CT显像阴性和阳性者PFS分别为63.56和19.23个月（P=0.000），化疗中后期组首次PET/CT显像阴性和阳性者的PFS分别为65.78和24.32个月（P=0.000）。化疗中期组和中后期组首次PET/CT显像阴性者PFS时间无显著性差异（63.56 vs 65.78个月，P=0.613）；化疗中期组和中后期组首次PET/CT显像阳性者PFS时间也无显著性差异（19.23 vs 24.32个月，P=0.274）。PFS率比较，化疗中期组首次PET/CT显像阴性和阳性者PFS率分别为73.3%、15.4%（χ2=12.423，P=0.000）；化疗中后期组首次PET/CT显像阴性和阳性者PFS率分别为74.5%、16.7%（χ2=12.423，P=0.000）。化疗中期组和中后期组首次PET/CT显像阴性者的PFS率无明显统计学差异（73.3%vs74.5%，P=0.613）；化疗中期和中后期组首次PET/CT显像阳性者的PFS率也无显著统计学差异（15.4%vs 16.7%，P=0.274）。结论 DLBCL在化疗中期和化疗中后期进行18F-FDG PET/CT显像均可较好地判断预后，在化疗中后期行PET/CT显像判断预后并不优于化疗中期，因此在化疗中期行18F-FDG PET/CT进行预测预后是合适的，不必延后到化疗中后期。目的：探討瀰漫大B細胞淋巴瘤（DLBCL）患者在化療中期和中後期進行18F-FDG PET/CT顯像判斷預後的價值差異。方法 DLBCL初診患者142例，于標準化療第3~4箇療程結束進行首次18F-FDG PET/CT評價為化療中期組，于標準化療5~8箇療程結束進行首次PET/CT評價者為化療中後期組，兩組各有71例，首次PET/CT顯像結果記錄為陰性和暘性。所有患者隨訪18~114箇月（平均28.73箇月），根據隨訪結果計算無進展生存時間（PFS）和無進展生存率（PFS%），比較化療中期組與中後期組患者首次18F-FDG PET/CT顯像結果與預後的關繫。結果化療中期組18F-FDG PET/CT顯像陰性和暘性率分彆為63.4%、36.6%，化療中後期組PET/CT顯像陰性和暘性率分彆為66.2%、33.8%，兩組PET/CT顯像陰性率及暘性率無明顯差異（χ2=12.423，P>0.05）。PFS比較，化療中期組首次18F-FDG PET/CT顯像陰性和暘性者PFS分彆為63.56和19.23箇月（P=0.000），化療中後期組首次PET/CT顯像陰性和暘性者的PFS分彆為65.78和24.32箇月（P=0.000）。化療中期組和中後期組首次PET/CT顯像陰性者PFS時間無顯著性差異（63.56 vs 65.78箇月，P=0.613）；化療中期組和中後期組首次PET/CT顯像暘性者PFS時間也無顯著性差異（19.23 vs 24.32箇月，P=0.274）。PFS率比較，化療中期組首次PET/CT顯像陰性和暘性者PFS率分彆為73.3%、15.4%（χ2=12.423，P=0.000）；化療中後期組首次PET/CT顯像陰性和暘性者PFS率分彆為74.5%、16.7%（χ2=12.423，P=0.000）。化療中期組和中後期組首次PET/CT顯像陰性者的PFS率無明顯統計學差異（73.3%vs74.5%，P=0.613）；化療中期和中後期組首次PET/CT顯像暘性者的PFS率也無顯著統計學差異（15.4%vs 16.7%，P=0.274）。結論 DLBCL在化療中期和化療中後期進行18F-FDG PET/CT顯像均可較好地判斷預後，在化療中後期行PET/CT顯像判斷預後併不優于化療中期，因此在化療中期行18F-FDG PET/CT進行預測預後是閤適的，不必延後到化療中後期。
목적：탐토미만대B세포림파류（DLBCL）환자재화료중기화중후기진행18F-FDG PET/CT현상판단예후적개치차이。방법 DLBCL초진환자142례，우표준화료제3~4개료정결속진행수차18F-FDG PET/CT평개위화료중기조，우표준화료5~8개료정결속진행수차PET/CT평개자위화료중후기조，량조각유71례，수차PET/CT현상결과기록위음성화양성。소유환자수방18~114개월（평균28.73개월），근거수방결과계산무진전생존시간（PFS）화무진전생존솔（PFS%），비교화료중기조여중후기조환자수차18F-FDG PET/CT현상결과여예후적관계。결과화료중기조18F-FDG PET/CT현상음성화양성솔분별위63.4%、36.6%，화료중후기조PET/CT현상음성화양성솔분별위66.2%、33.8%，량조PET/CT현상음성솔급양성솔무명현차이（χ2=12.423，P>0.05）。PFS비교，화료중기조수차18F-FDG PET/CT현상음성화양성자PFS분별위63.56화19.23개월（P=0.000），화료중후기조수차PET/CT현상음성화양성자적PFS분별위65.78화24.32개월（P=0.000）。화료중기조화중후기조수차PET/CT현상음성자PFS시간무현저성차이（63.56 vs 65.78개월，P=0.613）；화료중기조화중후기조수차PET/CT현상양성자PFS시간야무현저성차이（19.23 vs 24.32개월，P=0.274）。PFS솔비교，화료중기조수차PET/CT현상음성화양성자PFS솔분별위73.3%、15.4%（χ2=12.423，P=0.000）；화료중후기조수차PET/CT현상음성화양성자PFS솔분별위74.5%、16.7%（χ2=12.423，P=0.000）。화료중기조화중후기조수차PET/CT현상음성자적PFS솔무명현통계학차이（73.3%vs74.5%，P=0.613）；화료중기화중후기조수차PET/CT현상양성자적PFS솔야무현저통계학차이（15.4%vs 16.7%，P=0.274）。결론 DLBCL재화료중기화화료중후기진행18F-FDG PET/CT현상균가교호지판단예후，재화료중후기행PET/CT현상판단예후병불우우화료중기，인차재화료중기행18F-FDG PET/CT진행예측예후시합괄적，불필연후도화료중후기。
Objective To compare the value of 18F-FDG PET/CT performed in the interim and later phase of chemotherapy in predicting the prognosis of diffuse large B-cell lymphoma (DLBCL). Methods 18F-FDG PET/CT was performed in 71 patients with DLBCL in the interim phase of chemotherapy (3-4 cycles) and in another 71 patients in the later phase of chemotherapy (5-8 cycles). The patients were followed up for an average of 28.73 months (18-114 months) to compare the progression-free survival (PFS) and the PFS rate. Results The positive finding rate was similar between 18F-FDG PET/CT performed in the interim and the later phase (36.6%vs 33.8%,χ2=12.423, P>0.05). The PFS was much longer in patients with negative findings than in those with positive findings in both the interim (63.56 vs 19.23 months, P=0.000) and later phase groups (65.78 vs 24.32 months, P=0.000), but showed no significant difference between the negative patients (P>0.05) or between the positive patients (P>0.05) in the two groups. The PFS rate was significantly greater in patients with negative than those with positive findings in the interim group (73.3%vs 15.4%, P=0.000) and in the later phase group (74.5%vs 16.7%, P=0.000), but comparable between the negative (P>0.05) and between the positive patients (P>0.05) in the two groups. Conclusions 18F-FDG PET/CT in the interim and later phase of chemotherapy has similar value for predicting the prognosis of DLBCL, and we therefore recommend that 18F-FDG PET/CT be performed in the interim but not in the later phase.