南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (02): 208-.

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弥漫大B细胞淋巴瘤化疗中后期用18F-FDG PET/CT显像预测预后是否优于化疗中期？

李蕙旨，吴湖炳，王全师，李洪生，周文兰，田颖，董烨   

  • 出版日期:2015-02-20 发布日期:2015-02-20

18F-FDG PET/CT for predicting outcomes of diffuse large B-cell lymphoma: shall it be
performed in the interim versus later phase of chemotherapy?

  • Online:2015-02-20 Published:2015-02-20

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摘要： 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。

Abstract: 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.