摘要目的:探讨基线 18F－FDG PET/CT代谢参数及相关临床因素在血管免疫母细胞性T细胞淋巴瘤(AITL)患者预后评估中的价值。 方法:回顾性分析2013年7月至2023年12月间来自南京中医药大学鼓楼临床医学院(32例)以及南京医科大学第一附属医院(38例)经病理确诊、并在治疗前接受PET/CT显像的70例AITL患者[男44例、女26例；年龄(63.9±9.6)岁]。收集患者的PET/CT代谢参数(采用41%SUV max阈值方法计算得出)及相关临床参数。利用ROC曲线确定代谢参数的最佳临界值。采用Cox比例风险回归模型进行预后分析，并构建预测模型；通过校准曲线与时间依赖ROC曲线评估模型效能。 结果:随访19.0(10.0，33.3)个月，51例患者疾病进展或复发，28例患者死亡。ROC曲线示总肿瘤代谢体积(TMTV)、病灶糖酵解总量(TLG)、SUV max诊断AITL的最佳临界值分别为767.1cm 3、2159.6g、13.0。Cox多因素分析结果示，TMTV[风险比( HR)＝0.485，95% CI：0.252~0.935， P＝0.031]和性别( HR＝0.441，95% CI：0.236~0.824， P＝0.010)是无进展生存(PFS)预后的独立危险因素；TMTV( HR＝0.422，95% CI：0.178~0.997， P＝0.049)和治疗方案( HR＝0.346，95% CI: 0.154~0.777， P＝0.010)是总生存(OS)预后的独立危险因素。时间依赖ROC曲线结果表明，TMTV联合性别或治疗方案的联合模型在预测AITL患者PFS(AUC范围：0.67~0.82)或OS(AUC范围：0.62~0.80)方面具有更好的效能；校准曲线显示，联合模型的预测值与实际值具有较好的一致性。 结论:代谢参数TMTV是AITL患者PFS与OS的独立危险因素，其分别与性别、治疗方案结合的联合模型可有效提高AITL患者PFS、OS的预测效能。

abstractsObjective:To explore the value of baseline 18F-FDG PET/CT metabolic parameters and related clinical factors in the prognostic assessment of patients with angioimmunoblastic T-cell lymphoma (AITL). Methods:From July 2013 to December 2023, 70 patients with AITL (44 males, 26 females, age (63.9±9.6) years) from Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University (32 cases) as well as the First Affiliated Hospital of Nanjing Medical University (38 cases) who were diagnosed pathologically and underwent PET/CT imaging prior to treatment were retrospectively analyzed. PET/CT metabolic parameters (calculated using the 41%SUV max threshold method) and related clinical factors were collected. The optimal cut-off values of metabolic parameters were determined by using the ROC curve analysis. Cox proportional risk regression models were used for prognostic analyses, prediction models were constructed and efficacies were assessed by calibration curves and time-dependent ROC curves. Results:With the follow-up of 19.0(10.0, 33.3) months, disease progression or recurrence occurred in 51 patients, and 28 patients died. ROC curves showed that the optimal cut-off values on diagnosing AITL of total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and SUV max were 767.1cm 3, 2159.6g and 13.0, respectively. TMTV (hazard ratio ( HR)=0.485, 95% CI: 0.252-0.935, P=0.031) and gender ( HR=0.441, 95% CI: 0.236-0.824, P=0.010) were independent risk factors for progression-free survival (PFS); TMTV ( HR=0.422, 95% CI: 0.178-0.997, P=0.049) and treatment regimen ( HR=0.346, 95% CI: 0.154-0.777, P=0.010) were independent risk factors for overall survival (OS). Time-dependent ROC curves indicated that the combined model of TMTV combining gender or treatment regimen had better prognostic results in predicting PFS (AUCs: 0.67-0.82) or OS (AUCs: 0.62-0.80) in patients with AITL. The calibration curve showed the predicted values of the combined models were in good consistency with the actual values. Conclusions:The metabolic parameter TMTV is an independent risk factor for PFS and OS in patients with AITL. The combined model of TMTV combining gender or treatment regimen can effectively improve the prognostic prediction efficacy of PFS or OS in patients with AITL.