摘要目的 探讨18氟脱氧葡萄糖正电子发射成像(18F-FDG PET)/CT在弥漫大B细胞淋巴瘤(DLBCL)患者规范一线治疗结束后的预后意义.方法 回顾性分析在我院诊治的39例DLBCL患者资料.所有患者规范一线治疗结束后接受18F-FDG PET/CT检查,采用Kaplan-Meier方法对患者生存进行分析.结果 治疗后PET/CT结果分为阴性、轻度代谢和阳性.17例患者治疗后PET/CT结果为阴性,中位随访24.1个月均未复发；13例患者为轻度代谢,中位随访17.1个月,2例复发；9例患者为阳性,中位随访16.3个月,其中4例患者结合临床表现及其他影像学资料判定为病情进展并予以解救治疗,另2例分别在PET/CT检查后观察至13.5个月和6.8个月后病情进展,其余3例患者经病理组织活检证实为阴性,在PET/CT检查后分别观察至5.9、9.6和20个月均未进展.治疗后PET/CT阴性、轻度代谢、阳性患者的1年无进展生存(PFS)率分别为100％、83％和56％,2年PFS率分别为100％、83％和42％.阴性、轻度代谢、阳性患者的1年总生存(OS)率分别为100％、100％和89％,2年OS率分别为100％、100％和63％,治疗后PET/CT检查阳性组患者的2年总生存率与阴性组、轻度代谢组比较差异有统计学意义(P =0.004).结论 DLBCL患者规范一线治疗后PET/CT阴性及轻度代谢患者的预后相对较好,而治疗后PET/CT阳性患者预后相对较差.

abstractsObjective To evaluate the value of 18F-FDG PET/CT in detecting residual disease and predicting relapse following first-line treatment in patients with diffuse large B cell lymphoma (DLBCL).Methods The clinical data of 39 patients with DLBCL,who underwent PET/CT scan after first-line treatment,were analyzed retrospectively.Kaplan-Meier method was used to analyze the survival of patients.Results PET/CT findings were interpreted as negative,mild metabolism and positive.Seventeen patients'PET/CT findings were judged as negative,none of them relapsed with a median follow-up of 24.1 months,13 were judged as mild metabolism,2 of them relapsed with a median follow-up of 17.1 months.Of the rest 9 findings were judged as positive with a median follow-up of 16.3 months,4 patients were considered as disease progression according to clinical manifestations and other radiographic results,2 patients relapsed at the timepoints of 13.5 and 6.8 months after PET/CT scan respectively,the other 3 patients were diagnosed as negative by biopsy,none of them relapsed at the timepoints of 5.9,9.6 and 20.0 months after PET/CT scan respectively.One-year progression-free-survival (PFS) for negative,mild metabolism and positive groups was 100％,83％ and 56％,respectively.Two-year PFS was 100％,83％ and 42％,respectively.Overall survival (OS) at 1 year for negative,mild metabolism and positive groups was 100％,100％ and 89％,respectively.Two-year OS was 100％,100％ and 63％,respectively(P =0.004).Conclusion DLBCL patients with negative and mild metabolism PET/CT following first-line treatment had good prognosis,who needed no additional therapy.While patients with positive PET/CT had poor prognosis,those patients should receive biopsy before adjusting treatment regimen because of the high false-positive rate.