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iFLT-PET/CT是弥漫性大B细胞淋巴瘤化疗免疫治疗后无进展生存率的早期和优越预测指标

2021-07-29 MedSci原创 MedSci原创

弥漫性大B细胞淋巴瘤无进展生存率iFLT-PET/CT
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18F-氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)结合综合计算机断层扫描（FDG-PET/CT）是弥散大B细胞淋巴瘤(DLBCL)分期、再分期和治疗结束时疗效评估的成熟方法。虽然FDG-PET/CT对DLBCL的预测能力已在多项回顾性和前瞻性研究中得到证实，但iFDG-PET/CT对DLBCL的预测价值仍存在争议。

Minamimoto, R等开展了一项多中心前瞻性研究，在3年的中位随访期后，根据使用标准化的当代评估标准定义的PET中期扫描阳性和阴性患者的3年和5年无进展生存率，确定iFDG-PET/CT和iFLT-PET/CT的预测值。

探讨在利妥昔单抗、环磷酰胺、多柔比星、长春新碱和强的松（R-CHOP）或利妥昔单抗、足叶乙甙、强的松、长春新碱、环磷酰胺和多柔比星（R-EPOCH）治疗的弥漫性大B细胞淋巴瘤(DLBCL)患者中，3'-脱氧-3'-[18F]氟胸苷(iFLT)PET/CT是否优于18F-氟脱氧葡萄糖(iFDG)PET/CT预测无进展生存率(PFS)。

基于IFLT-PET/CT和Deauville标准的3年和5年PFS率

92例DLBCL患者在两个周期的R-CHOP/R-EPOCH后18～24d行FLT-PET/CT和FDG-PET/CT检查。采用Deauville标准、Percist1.0、标准化摄取值(SUV)、总病灶糖酵解(TLG)和代谢瘤体积等指标解释IFDG-PET/CT，并与3年和5年PFS结果进行比较。结果iFLT-PET/CT阴性67例(73%)，阳性25例（27%）。

iFLT-PET/CT阴性、iFLT-PET/CT阳性、Deauville分型阴性和阳性患者PFS的Kaplan-Meier图。iFLT-PET/CT阳性者PFS明显短于iFLT-PET/CT阴性者(P<.0001)，而Deauville阳性者与Deauville阴性者PFS无显著性差异(P=.1)。

iFLT-PET/CT阴性、iFLT-PET/CT阳性、Percist阴性和阳性患者PFS的Kaplan-Meier图。iFLT-PET/CT阳性患者的PFS明显短于iFLT-PET/CT阴性患者(P<.0001)，而PFS在PICIST阳性和PICIST阴性患者之间无差异(P=.21)。

采用Deauville标准的iFDG-PET/CT阴性53例（58%）,阳性39例（42%）。67例iFLT-PET/CT阴性患者中，7例（10.4%）中位进展为14.1个月，14/25例（56.0%）iFLT-PET/CT阳性患者中位进展为7.8个月(P<.0001)。53例Deauville阴性患者中，9例（17.0%）进展中位14.1个月，12/39例（30.8%）进展中位5.6个月(P=0.11)。在包括iFLT-PET/CT、PERCIST、中期TLG和中期SUVmax在内的多因素分析中，只有iFLT-PET/CT是3年和5年PFS的独立预测指标(P<.0001和P=.001)。

在给予R-CHOP/R-EPOCH治疗的DLBCL患者中，iFLT-PET/CT在定量评估和治疗评估标准上均优于iFDG-PET/CT, iFLT-PET/CT是优于iFDG-PET/CT的独立预后预测指标,并为FLT-PET/CT代替或补充FDG-PET/CT用于DLBCL的中期反应评估提供了理论依据，对改善患者管理有一定的意义。

原文出处

Minamimoto, R., Fayad, L., Vose, J. et al. 18F-Fluorothymidine PET is an early and superior predictor of progression-free survival following chemoimmunotherapy of diffuse large B cell lymphoma: a multicenter study. Eur J Nucl Med Mol Imaging 48, 2883–2893 (2021). https://doi.org/10.1007/s00259-021-05353-9

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    2021-10-13 feather89

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    2022-05-21 marlenexl

    #细胞淋巴瘤#

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time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407065, encodeId=938e140e06549, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438650, encodeId=cd631438650ea, content=<a href='/topic/show?id=9851500416c' target=_blank style='color:#2F92EE;'>#弥漫性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50041, encryptionId=9851500416c, topicName=弥漫性)], attachment=null, 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    2021-07-31 guoyibin

    #生存率#

    0

  4. 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    2021-07-31 xiaoyeshuang

    #B细胞#

    0

  5. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003646, encodeId=f203100364620, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201221/3beb013aa9464592a5be8db933b111c6/6db3d0536fc34cd98f4a8c83ecd79486.jpg, createdBy=e3765446490, createdName=ms9000000710711657, createdTime=Thu Jul 29 20:17:34 CST 2021, time=2021-07-29, status=1, ipAttribution=)]
    2021-07-31 bnjfy

    #弥漫性大B细胞淋巴瘤#

    0

  6. 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time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407065, encodeId=938e140e06549, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438650, encodeId=cd631438650ea, content=<a href='/topic/show?id=9851500416c' target=_blank style='color:#2F92EE;'>#弥漫性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50041, encryptionId=9851500416c, topicName=弥漫性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003646, encodeId=f203100364620, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201221/3beb013aa9464592a5be8db933b111c6/6db3d0536fc34cd98f4a8c83ecd79486.jpg, createdBy=e3765446490, createdName=ms9000000710711657, createdTime=Thu Jul 29 20:17:34 CST 2021, time=2021-07-29, status=1, ipAttribution=)]
    2021-07-31 chaojitidian

    #PET/CT#

    0

  7. 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createdBy=201630414353, createdName=marlenexl, createdTime=Sat May 21 09:27:18 CST 2022, time=2022-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1256842, encodeId=2f3712568426f, content=<a href='/topic/show?id=43706900963' target=_blank style='color:#2F92EE;'>#生存率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69009, encryptionId=43706900963, topicName=生存率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6a6043, createdName=guoyibin, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1273402, encodeId=3b6e12e3402f5, content=<a href='/topic/show?id=310d383ef5' target=_blank style='color:#2F92EE;'>#B细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3837, encryptionId=310d383ef5, topicName=B细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290177, encodeId=045612901e746, content=<a href='/topic/show?id=c5795004ece' target=_blank style='color:#2F92EE;'>#弥漫性大B细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50047, encryptionId=c5795004ece, topicName=弥漫性大B细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, createdName=bnjfy, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309700, encodeId=2f131309e00df, content=<a href='/topic/show?id=412114080d1' target=_blank style='color:#2F92EE;'>#PET/CT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14080, encryptionId=412114080d1, topicName=PET/CT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=295c372, createdName=chaojitidian, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331187, encodeId=89e2133118efc, content=<a href='/topic/show?id=15e2140e438' target=_blank style='color:#2F92EE;'>#PET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14074, encryptionId=15e2140e438, topicName=PET)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTI5PdY90y5Jib8FnPhCXTR2d9v3K17epNSwB2eb0vmXUldNJl2e72S4unZTAHLAojicdVSialTDFHAxA/132, createdBy=78d82500042, createdName=ms7514935887898259, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407065, encodeId=938e140e06549, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438650, encodeId=cd631438650ea, content=<a href='/topic/show?id=9851500416c' target=_blank style='color:#2F92EE;'>#弥漫性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50041, encryptionId=9851500416c, topicName=弥漫性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003646, encodeId=f203100364620, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201221/3beb013aa9464592a5be8db933b111c6/6db3d0536fc34cd98f4a8c83ecd79486.jpg, createdBy=e3765446490, createdName=ms9000000710711657, createdTime=Thu Jul 29 20:17:34 CST 2021, time=2021-07-29, status=1, ipAttribution=)]
    2021-07-31 ms7514935887898259

    #PET#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1729058, encodeId=68af1e290589b, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Wed Oct 13 02:27:18 CST 2021, time=2021-10-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1702683, encodeId=6d581e0268306, content=<a href='/topic/show?id=ddc9e795159' target=_blank style='color:#2F92EE;'>#细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77951, encryptionId=ddc9e795159, topicName=细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encryptionId=310d383ef5, topicName=B细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6eba113, createdName=xiaoyeshuang, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1290177, encodeId=045612901e746, content=<a href='/topic/show?id=c5795004ece' target=_blank style='color:#2F92EE;'>#弥漫性大B细胞淋巴瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50047, encryptionId=c5795004ece, topicName=弥漫性大B细胞淋巴瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=346311, createdName=bnjfy, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1309700, encodeId=2f131309e00df, content=<a href='/topic/show?id=412114080d1' target=_blank style='color:#2F92EE;'>#PET/CT#</a>, beContent=null, objectType=article, 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time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407065, encodeId=938e140e06549, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438650, encodeId=cd631438650ea, content=<a href='/topic/show?id=9851500416c' target=_blank style='color:#2F92EE;'>#弥漫性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50041, encryptionId=9851500416c, topicName=弥漫性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003646, encodeId=f203100364620, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201221/3beb013aa9464592a5be8db933b111c6/6db3d0536fc34cd98f4a8c83ecd79486.jpg, createdBy=e3765446490, createdName=ms9000000710711657, createdTime=Thu Jul 29 20:17:34 CST 2021, time=2021-07-29, status=1, ipAttribution=)]
    2021-07-31 anminleiryan

    #预测指标#

    0

  9. 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time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407065, encodeId=938e140e06549, content=<a href='/topic/show?id=fa7c100231a5' target=_blank style='color:#2F92EE;'>#预测指标#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100231, encryptionId=fa7c100231a5, topicName=预测指标)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10c72588657, createdName=anminleiryan, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1438650, encodeId=cd631438650ea, content=<a href='/topic/show?id=9851500416c' target=_blank style='color:#2F92EE;'>#弥漫性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50041, encryptionId=9851500416c, topicName=弥漫性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Jul 31 09:27:18 CST 2021, time=2021-07-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1003646, encodeId=f203100364620, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201221/3beb013aa9464592a5be8db933b111c6/6db3d0536fc34cd98f4a8c83ecd79486.jpg, createdBy=e3765446490, createdName=ms9000000710711657, createdTime=Thu Jul 29 20:17:34 CST 2021, time=2021-07-29, status=1, ipAttribution=)]
    2021-07-31 zhouqu_8

    #弥漫性#

    0

  10. 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    2021-07-29 ms9000000710711657

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