摘要
目的:分析弥漫大B细胞淋巴瘤(DLBCL)基线^(18)F-氟代脱氧葡萄糖正电子发射断层成像/计算机断层扫描(^(18)F-FDG PET/CT)与循环肿瘤DNA(ctDNA)各参数之间的相关性,并对比两种方法在DLBCL预后评估中的价值。方法:回顾性分析2018年8月至2021年4月间50例经病理证实的DLBCL患者,男性26例,女性24例,中位年龄55.5(43.5,64.0)岁。收集患者的PET/CT参数,包括最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、糖酵解总量(TLG),ctDNA参数,包括突变数、突变基因数、平均突变丰度(meanVAF),以及患者临床资料。分析PET/CT和ctDNA参数与患者临床特征的关系,PET/CT参数与ctDNA参数的相关性,比较PET/CT和ctDNA参数预测预后的诊断效能。随访36-69个月,计算无进展生存(PFS)期,并进行生存分析。结果:PET/CT参数均与ctDNA参数具有良好相关性,其中MTV与突变数、突变基因数、meanVAF均呈中度相关(rs=0.72,0.64,0.71),TLG与突变数呈强相关(rs=0.83),与突变基因数、meanVAF呈中度相关(rs=0.72,0.79),而SUVmax与突变数、突变基因数、meanVAF间均呈弱相关(rs=0.47,0.46,0.47)。PET/CT参数与ctDNA参数在预测DLBCL预后准确性与ROC曲线下面积AUC间差异均无统计学意义(P>0.05),但MTV、TLG对1、2和3年PFS预测预后的特异性均优于meanVAF(均P<0.05),而meanVAF对1、2和3年PFS预测预后的灵敏度优于MTV(均P<0.05)。通过ROC曲线获得SUVmax、MTV、TLG、突变数、突变基因数、meanVAF预测肿瘤进展的最佳界值,根据最佳界值将患者分为高低表达两组并进行生存分析,结果显示高低表达组间PFS差异均有统计学意义(均P<0.05)。结论:基线^(18)F-FDG PET/CT和ctDNA参数均能预测DLBCL预后,且两者在DLBCL预后判断中的价值相当。
Objective:To analyze the correlation between baseline^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT)and circulating tumor DNA(ctDNA)parameters in diffuse large B-cell lymphoma(DLBCL)and compare the value of the two methods in the prognosis assessment of DLBCL.Methods:A total of 50 DLBCL patients confirmed by pathology,including 26 males and 24 females,with a median age of 55.5(43.5,64.0)years from August 2018 to April 2021 were retrospectively analyzed.PET/CT parameters,including maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV),total lesion glycolysis(TLG),ctDNA parameters,including mutation number,mutation gene number,mean variant allele frequency(meanVAF),and clinical data of patients were collected.The relationship between PET/CT,ctDNA parameters and patient clinical features was analyzed,as well as the correlation between PET/CT and ctDNA parameters.The diagnostic efficacy of PET/CT and ctDNA parameters was compared.Patients were followed up for 36-69 months.Progression-free survival(PFS)was calculated,and survival analysis was performed.Results:PET/CT parameters all had good correlation with ctDNA parameters,among which MTV was moderately correlated with mutation number,mutation gene number,and meanVAF(rs=0.72,0.64,0.71),TLG was strongly correlated with mutation number(rs=0.83)and moderately correlated with mutation gene number and mean VAF(rs=0.72,0.79),while SUVmax was weakly correlated with mutation number,mutation gene number and meanVAF(rs=0.47,0.46,0.47).PET/CT parameters and ctDNA parameters showed no statistically significant differences in predicting the prognosis of DLBCL and area under the curve(AUC)of receiver operating characteristic(ROC)(P>0.05).However,the specificity of MTV and TLG in predicting prognosis of 1-,2-and 3-year PFS was better than that of meanVAF(all P<0.05),while the sensitivity of meanVAF in predicting prognosis of 1-,2-and 3-year PFS was better than that of MTV(all P<0.05).The optimal cut-of f values of SUVmax,MTV,TLG,mutation number,mutation gene number and meanVAF in predicting tumor progression were obtained using ROC curve analysis.Patients were divided into high and low expression groups according to the cut-of f values and survival analysis was performed.The results of survival analysis showed that there were statistically significant differences in PFS between the high and low expression groups(all P<0.05).Conclusion:Baseline^(18)F-FDG PET/CT and ctDNA parameters can both predict the prognosis of DLBCL,and are equally valuable in the evaluation of DLBCL prognosis.
作者
李佳琳
王蕊
白敏
邢军
原凌
LI Jia-Lin;WANG Rui;BAI Min;XING Jun;YUAN Ling(Department of Nuclear Medicine,The First Hospital of Shanxi Medical University,Shanxi Key Laboratory of Molecular Imaging,Collaborative Innovation Center for Molecular Imaging of Precision Medicine,Taiyuan 030001,Shanxi Province,China;Department of Hematology,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,Shanxi Province,China;Department ofNuclear Medicine(PET/CT),Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,Shanxi Province,China)
出处
《中国实验血液学杂志》
北大核心
2025年第5期1335-1343,共9页
Journal of Experimental Hematology
基金
山西省自然科学基金(202203021211046)
山西省“四个一批”引导性科技专项基金(2021XM49)。
