摘要目的:对比化疗中期淋巴瘤疗效评价标准(RECIL)与Lugano标准在 18F－FDG亲和性高的霍奇金淋巴瘤(HL)和非霍奇金淋巴瘤(NHL)患者中的疗效及预后评价作用。 方法:回顾性分析2015年1月至2021年8月在山西省肿瘤医院初诊的经病理证实的240例淋巴瘤患者[男149例、女91例，年龄50.0(32.0，62.0)岁]，患者均于治疗前及治疗中期行 18F－FDG PET/CT显像。比较不同类型淋巴瘤患者PET/CT显像结果差异( χ2检验或Kruskal－Wallis秩和检验)。在化疗中期进行疗效评价，依据Lugano标准，疗效分为完全缓解(CR)、部分缓解(PR)、疾病稳定(SD)、疾病进展(PD)；依据RECIL，疗效分为CR、PR、轻微缓解(MiR)、SD、PD。为了更好地与Lugano标准进行比较，将MiR分别纳入PR组(记作RECIL－1)及SD组(记作RECIL－2)。随访分析无进展生存(PFS)情况。采用 Kappa检验、 χ2检验或Fisher确切概率法分析数据，采用ROC曲线比较不同标准的预测效能。 结果:240例中，HL 96例、滤泡型淋巴瘤(FL)30例、弥漫性大B细胞淋巴瘤(DLBCL)114例。不同类型淋巴瘤患者的病灶基线SUV max( H＝54.96， P<0.001)、最大径总和(SLD)( H＝15.85， P<0.001)的差异均有统计学意义。随访12~89个月，依据RECIL评价时，26例(10.8%)患者评估为MiR。RECIL－1、RECIL－2与Lugano标准在化疗中期疗效评价结果的一致性( Kappa)分别为0.84和0.74(均 P<0.001)。依据Lugano标准，CR、PR、SD、PD患者的PFS率分别为91.4%(148/162)、57.1%(36/63)、1/3和3/12；依据RECIL－1的对应结果分别为91.3%(136/149)、62.8%(49/78)、1/2和2/11；依据RECIL－2的对应结果分别为91.3%(136/149)、57.7%(30/52)、71.4%(20/28)和2/11；不同标准各反应类别患者间PFS率的差异有统计学意义( χ2值：46.64~52.44，均 P<0.001)。Lugano标准预测PFS的AUC略高于RECIL－1及RECIL－2的AUC(0.774、0.758和0.746； z值：1.28和1.61， P值：0.200和0.107)。 结论:化疗中期RECIL与Lugano标准对 18F－FDG亲和性高的HL和NHL患者疗效及预后评价作用相当。

abstractsObjective:To compare the efficacy and prognostic evaluation of response evaluation criteria in lymphoma (RECIL) and Lugano classification in patients with 18F-FDG-avid Hodgkin′s lymphoma (HL) and non-HL (NHL) during mid-chemotherapy. Methods:From January 2015 to August 2021, 240 patients (149 males and 91 females, age 50.0(32.0, 62.0) years) with pathologically confirmed lymphoma in Shanxi Cancer Hospital were retrospectively analyzed. Pre-treatment and mid-treatment 18F-FDG PET/CT examinations were performed, and the differences of PET/CT imaging results among patients with different types of lymphoma were analyzed ( χ2 test or Kruskal-Wallis rank sum test). Efficacy evaluation was conducted during mid-chemotherapy, and the results were divided into complete remission (CR), partial remission (PR), stable disease (SD), progressive disease (PD) according to Lugano classification, which were divided into CR, PR, mild remission (MiR), SD, PD according to RECIL. For the better comparison with Lugano classification, MiR was included in PR group (recorded as RECIL-1) and SD group (recorded as RECIL-2) in this study. All patients were followed up, and the progression free survival (PFS) was analyzed. Kappa test, χ2 test or Fisher exact probability method were used to analyze the data, and ROC curve was used to compare the prediction efficiency of different standards. Results:Among 240 patients with different types of lymphoma (96 HL, 30 follicular lymphoma (FL), 114 diffuse large B-cell lymphoma (DLBCL)), there were statistically significant differences in baseline SUV max ( H=54.96, P<0.001) and the sum of longest diameters ( H=15.85, P<0.001). Patients were followed up for 12-89 months, and 26 patients (10.8%) were evaluated as MiR according to the RECIL. The consistency ( Kappa) was 0.84 between results of RECIL-1 and Lugano classification, which was 0.74 between RECIL-2 and Lugano classification (both P<0.001). According to Lugano classification, the PFS rates of patients evaluated as CR, PR, SD and PD were 91.4%(148/162), 57.1%(36/63), 1/3 and 3/12 respectively, which were 91.3%(136/149), 62.8%(49/78), 1/2 and 2/11 for RECIL-1, and 91.3%(136/149), 57.7%(30/52), 71.4%(20/28) and 2/11 for RECIL-2 respectively ( χ2 values: 46.64-52.44, all P<0.001). The AUC of Lugano classification for predicting PFS had a trend to be higher than AUCs of RECIL-1 and RECIL-2 (0.774, 0.758 and 0.746; z values: 1.28, 1.61, P values: 0.200, 0.107). Conclusion:RECIL and Lugano classification have similar efficacy and prognostic evaluation effect on patients with 18F-FDG-avid HL and NHL during mid-chemotherapy.