PET代谢参数在结外鼻型NK/T细胞淋巴瘤中的预后价值

莫奕文; 李璐; 李沅桦; 龙文; 张旭; 雷丹; 樊卫

doi:10.19732/j.cnki.2096-6210.2019.05.004

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PET代谢参数在结外鼻型NK/T细胞淋巴瘤中的预后价值

论著 | 更新时间：2025-12-15

- PET代谢参数在结外鼻型NK/T细胞淋巴瘤中的预后价值
- Prognostic value of PET metabolic parameters in patients with extranodal NK/T-cell lymphoma, nasal type
- 肿瘤影像学 2019年28卷第5期页码：306-314
- 作者机构：
- 作者简介：
- 基金信息：
  
  广东省自然科学基金（PT07390101）。
- DOI：10.19732/j.cnki.2096-6210.2019.05.004
  中图分类号：
- 网络出版：2019-10-28，
  
  纸质出版：2019-10-28
- 稿件说明：
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莫奕文,李璐,李沅桦,等. PET代谢参数在结外鼻型NK/T细胞淋巴瘤中的预后价值[J]. 肿瘤影像学, 2019, 28(5): 306-314 https://doi.

org/10.19732/j.cnki.2096-6210.2019.05.004
莫奕文,李璐,李沅桦,等. PET代谢参数在结外鼻型NK/T细胞淋巴瘤中的预后价值[J]. 肿瘤影像学, 2019, 28(5): 306-314 https://doi. DOI： 10.19732/j.cnki.2096-6210.2019.05.004.

org/10.19732/j.cnki.2096-6210.2019.05.004 DOI：

摘要

目的：

探讨PET代谢参数最大标准摄取值（maximum standardized uptake value，SUVmax）、全身肿瘤代谢体积（whole-body metabolic tumor volume，WBMTV）和全身总糖酵解率（whole-body total lesion glycolysis，WBTLG）在初诊结外鼻型NK/T细胞淋巴瘤（extranodal NK/T-cell lymphoma，nasal type，ENKTL）中的预后预测价值。

方法：

回顾性分析35例常规治疗前行

F-FDG PET/CT检查的初诊ENKTL患者。以41%SUVmax为阈值勾画出所有病灶的感兴趣体积（volume of interest，VOI），记录每个VOI的SUVmax、肿瘤代谢体积（metabolic tumor volume，MTV）和总糖酵解率（total lesionglycolysis，TLG）。手动计算各个VOI的MTV、TLG的总和分别为WBMTV、WBTLG。使用X-tile软件寻找PET代谢参数预测总生存率（overall survival，OS）的临界值并将其分为高、低两组。用Kaplan-Meier法绘制生存曲线，Log-Rank进行比较。单因素、多因素Cox回归确定与OS、无进展生存率（progression-free survival，PFS）相关的因素。

结果：

所纳入患者的中位随访时间为36个月，截止至分析，13例患者死亡，13例患者出现疾病进展。X-tile软件提示SUVmax、WBMTV、WBTLG的临界值分别为14.34、11.28 cm

、303.79。高、低两组SUVmax的3年生存率分别为41.2%、83.3%，差异有统计学意义（

=0.008）；高、低两组WBTLG的3年生存率分别为25.0%、74.1%，差异有统计学意义（

=0.006）。单因素分析的阳性预测因子有：SUVmax（HR：4.9，95% CI：1.3~17.9，

=0.016）、WBTLG（HR：4.2，95% CI：1.4~12.7，

=0.012）。多因素分析显示，WBTLG是OS的独立预后因子（HR：0.308，95% CI：0.100~0.952，

=0.041）。

结论：

治疗前高SUVmax、高WBTLG是NK/T细胞淋巴瘤OS的预后不良因素，WBTLG是OS最佳的独立预后因子。

Abstract

Objective:

To evaluate the value of PET parameters including maximum standard uptake value (SUVmax)

wholebody metabolic tumor volume (WBMTV)

whole-body total lesion glycolysis (WBTLG) in predicting the progression-free survival (PFS) and overall survival (OS) of extranodal NK/T-cell lymphoma

nasal type (ENKTL).

Methods:

Retrospective analysis was performed on 35 initial ENKTL who underwent

F-FDG PET/CT examination before treatment. The volume of interests (VOI) of all lesions were measured automatically based on 41% SUVmax thresholds

and then SUVmax

metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of each VOI were recorded. WBMTV and WBTLG were calculated manually for all VOI. X-tilesoftware was used to find the cutoff values of PET parameters. Survival curves were produced by Kaplan-Meier method and compared by Log-Rank test. Univariate and multivariate Cox regression were used to identify the factors related to OS and PFS.

Results:

The median follow-up period of the patients was 36 months and 13 patients showed disease progression and 13 patients died from the disease during the follow-up period. X-tile software showed cut-off values for SUVmax

WBMTV

WBTLG of 13.34

11.28 cm

303.79

respectively. Compared to low SUVmax and WBTLG

high SUVmax and WBTLG were significantly associated with poor 3-year OS rate (41.2% vs 83.3% for SUVmax

=0.008

and 25.0% vs 74.1% for WBTLG

=0.006). Univariate analysis indicated that SUVmax and WBTLG were significant predictors of OS (HR: 4.9

95% CI: 1.3-17.9

=0.016 for SUVmax

and HR: 0.308

95% CI: 0.100-0.952

=0.041 for WBTLG). Multiple analysis showed that WBTLG was the best predictor of OS (HR: 0.308

95% CI: 0.100-0.952

=0.041).

Conclusion:

High SUVmax and high WBTLG were poor prognostic factors on OS of the initial ENKTL

and WBTLG was

the best independent predictor of OS.

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