18F-FDGPETCT在弥漫性大B细胞淋巴瘤临床分期及-南京医科大学.doc

18F-FDG PET/CT在弥漫性大B细胞淋巴瘤临床分期及评价化疗反应的价值 [摘要] 目的: 探讨18F-FDG PET/CT在弥漫性大B细胞淋巴瘤(diffuse B-cell large lymphoma，DLBCL)临床分期及评价化疗中期治疗反应的价值。方法:29例初诊的DLBCL化疗前和化疗中期均行18F-FDG PET/CT检查，根据肿瘤对化疗的反应将病例分为无反应组、部分反应组及完全反应组，比较三组患者的完全缓解率。应用SPSS17.0软件进行统计学分析，完全缓解率的比较采用χ2检验和Fisher确切概率法检验。结果 :18F-FDG PET/CT改变了10.3%(3/29)患者的临床分期。无反应组、部分反应组及完全反应组的临床完全缓解率分别为16.7%（1/6）、69.7% (9/13) 和80.0% (8/10)，3组间差异有统计学意义（χ2=，P=0.0（χ2=4.310，P=0.038；χ2=5.730，P=0.017）18F-FDG PET/CT显像有助于临床分期；化疗中期18F-FDG PET/CT显像有助于预测化疗疗效。 [关键词] 淋巴瘤，大B细胞，弥漫性；药物疗法；正电子发射型计算机断层扫描；18氟-氟代脱氧葡萄糖；临床分期 The value of 18F-FDG PET/CT for clinical staging and assessing therapeutic response to chemotherapy in patients with diffuse large B-cell lymphoma [Abstract] Objective: To explore the value of 18F-FDG PET/CT on the clinical staging and assessment of chemotherapy response in patients with diffuse large B-cell lymphoma (DLBCL). Methods: 18F-FDG PET/CT was performed before and after 3 or 4 cycles of chemotherapy in 29 patients with DLBCL. The patients were divided into three groups: no response group, partial response group and complete response group. Compared the complete remission rate （CR）between the three groups. χ2 test and Fisher exact test was performed with SPSS 17.0. Results: The stage of disease was changed in three patients (10.3%, 3/29)on the basis of pre-treatment 18F-FDG PET/CT. CR rates of no response group, partial response group and complete response group were 16.7%, 69.7% and 80.0%, respectively（χ2=，P=0.0χ2=4.310，P=0.038；χ2=5.730，P=0.01718F-FDG PET/CT may be useful for clinical staging and assessment of chemotherapy response in DLBCL. [key words ] Lymphoma, large B-cell, diffuse; Drug therapy; Positron emission tomography; Fluorine-18 fluoro-deoxy-glucose; Clinical staging 弥漫大B细胞淋巴瘤(diffuse B-cell large lymphoma，DLBCL)是成人淋巴瘤中最常见的一种类型[1]，联合化疗方案已使DLBCL由不可治愈性疾病变为潜在可治愈疾病。但由于DLBCL具有较强的异质性，如何客观地进行临床分期及评价化疗反应，对制定个体化治疗方案显得尤为重要。18F-FDG PET/CT是一种全身、无创的功能代谢显像，可以准确的进行临床分期，并通过化疗前后病灶代谢的变化来评价治疗反应。笔者回顾性分析33例患者18F-FDG PET/CT显像结果