Blood:代谢异质性和总肿瘤病灶糖酵解均可作为原发纵膈B细胞淋巴瘤(PMBCL)预后预测标志物

2018-05-03 MedSci MedSci原创

中心点:18FDG-PET/CT上的代谢异质性:或许可作为PMBCL的预后指标。目前,高TLG结合高MH,可鉴别传统治疗后病程进展高风险的患者。摘要:在原发性纵膈B细胞淋巴瘤(PMBCL)的治疗过程中,一个重要的尚未满足的要求是鉴别一线治疗会失败的患者,以便在淋巴瘤进展成难治性的之前予以干预。在正电子发射断层扫描(PET/CT)上,瘤内18F-氟脱氧葡萄糖(18FDG)摄取分别的高度异质性被认为是

中心点:

18FDG-PET/CT上的代谢异质性:或许可作为PMBCL的预后指标。

目前,高TLG结合高MH,可鉴别传统治疗后病程进展高风险的患者。

摘要:

在原发性纵膈B细胞淋巴瘤(PMBCL)的治疗过程中,一个重要的尚未满足的要求是鉴别一线治疗会失败的患者,以便在淋巴瘤进展成难治性的之前予以干预。在正电子发射断层扫描(PET/CT)上,瘤内18F-氟脱氧葡萄糖(18FDG)摄取分别的高度异质性被认为是实体肿瘤化疗耐受性的可能的标志物。

在本研究中,Luca Ceriani等人对国际结外淋巴瘤研究中心(IWLSG)的26个前瞻性研究招募的103位PMBCL患者的代谢异质性(MH)的预后意义进行研究,明确PET在该淋巴瘤亚型中的作用。以累积SUV-体积直方图(AUC-CSH)方法曲线下的面积估计MH。低MH组和高MH组的5年无进展存活期(PFS)分别是94%和73%(p=0.0001)。在包含二分法MH、代谢肿瘤体积(MTV)、总病灶糖酵解(TLG)、国际预后指数(IPI)和肿瘤体积(纵膈肿块>10cm)的无进展存活期Cox模型中,以年龄为持续变量,仅TLG(p<0.001)和MH(p<0.001)仍具有统计学差异。

利用TLG和MH构建一简单的预测模型,使得早期精确的鉴别进展高风险的患者(PPV=89%,NPV≥90%),因此可进行风险适应性疗法。

本研究结果或许可为未来的临床试验涉及提供思路,并帮助少数化疗耐受性PMBCL患者。

原始出处:

Luca Ceriani,Metabolic heterogeneity on baseline 18FDG-PET/CT scan is a predictor of outcome in primary mediastinal B-cell lymphoma. Blood  2018  :blood-2018-01-826958;  doi: https://doi.org/10.1182/blood-2018-01-826958

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    2018-05-03 半夏微凉

    学习了谢谢分享

    0