18F-FDG PET／CT显像SUVmax＞2．5的病灶数及肿
瘤代谢体积对多发性骨髓瘤预后评估的价值
吴增杰;边甜甜;王艳丽;房娜;曾磊;崔新建
【期刊名称】《中华核医学与分子影像杂志》 【年(卷),期】2016(000)001
【摘要】Objective To investigate the effective indicators for the prognosis assessment in pa?tients with multiple myeloma (MM) by 18F?FDG PET/CT imaging. Methods A total of 36 patients(22 males, 14 females;median age 63.5 years) with MM confirmed by clinical or pathology from July 2007 to November 2014 were retrospectively reviewed. The number of lesions detected by PET/CT, the number of lesions with SUVmax>2.5, the SUVmax and MTV of each lesion were calculated. The correlation analysis was performed between the number of lesions detected by PET or CT,the number of lesions with SUVmax>2.5, the SUVmax , MTV and serumβ2?microglobulin (β2?M) , respectively. The patients were divided into differ?ent groups according to the development of lesions and the survival situation during the follow?up ( 4-92 months) . Kaplan?Meier analysis and multivariate Cox model were used to analyze the prognostic significance of the number of lesions detected by PET or CT and the number of lesions with SUVmax>2.5, the SUVmax and MTV. Results Both the number of lesions with SUVmax>2. 5 and MTV showed positive correlations with blood
β2?M (r=0.776, 0.954, both P<0.001), while the number of lesions detected by PET/CT and SUVmax were not correlated with β2?M ( r=0.053, 0.063, 0.398, all P>0.05) . The number of lesions with SUVmax>2.5 and MTV in the progressive group( n=14) were significantly higher than those in the regressive group(n=22):66.57±4.59 vs 31.95±4.75, t=4.95, P<0.001;(287.54±31.94) cm3 vs (72.17±14.35) cm3, t=6.93, P<0.001. The number of lesions with SUVmax>2.5 and MTV were significantly higher in the dead group(n=15) than those in the
survival
group(n=21):65.73±4.32
vs
30.90±4.87,
t=5.10,
P<0?001;(267.28±34.89) cm3 vs (76.39±15.67) cm3, t=5.49, P<0.001. The best cutoff values for predicting pro?gression?free survival and overall survival were both 42 for the number of lesions with SUVmax>2. 5, and those were 114.74 and 105.48 cm3 for MTV, respectively. The progression?free survival rate was worse in the patients with higher index than those with lower value (χ2=18.20, 29.74, both P<0.001) , and the same re?sult was also seen for the overall survival rate (χ2=19.07, 25.34, both P<0.001) . Conclusion The number of lesions with SUVmax>2.5 and MTV on 18 F?FDG PET/CT images could predict the progression?free survival and overall survival rates of patients with MM, which may provide accurate prognosis information.%目的：探讨18 F?FDG PET／CT显像评估多发性骨髓瘤（ MM）患者临床预后的有效指标。方法回顾性分析2007年7月至2014年11月间经临床或病理学证实的36例
MM患者（男22例，女14例，中位年龄63．5岁），分别记录治疗前PET／CT所示病灶数、SUVmax＞2．5的病灶数，并测定各病变SUVmax及MTV。将病灶数、SUVmax及MTV分别与治疗前血清β2?微球蛋白（β2?M）浓度进行相关性分析。对患者进行治疗后随访（4～92个月），根据病情发展情况及存活情况分组，应用 Kaplan?Meier法与Cox比例风险回归模型分别评估病灶数、SUVmax＞2．5的病灶数、SUVmax及MTV对临床预后的影响。结果 SUVmax＞2．5的病灶数及 MTV 与β2?M 浓度均呈正相关（ r＝0．776、0．954，均 P＜0?001）；CT及PET显示病灶数、SUVmax均与β2?M无相关性（ r＝0．053、0．063、0．398，均P＞0．05）。36例患者中，随访进展组14例，其SUVmax＞2．5的病灶数及MTV均大于缓解组（22例），相应指标：66．57±4．59与31．95±4．75，t＝4．95，P＜0．001；（287．54±31．94）与（72．17±14．35） cm3，t＝6．93，P＜0．001。按存活情况分组比较，死亡组（15例）SUVmax＞2．5的病灶数及MTV均大于生存组（21例）：65．73±4．32与30．90±4．87，t＝5．10，P＜0．001；（267．28±34．89）与（76．39±15．67） cm3， t＝5．49，P＜0．001。预测无进展生存率及总生存率的 SUVmax＞2．5的病灶数最佳阈值均为42，而 MTV 最佳阈值分别为114．74和105?48 cm3；相应指标高于最佳阈值组的患者较低于阈值组的患者病情易进展（（χ2＝18．20、29．74，均P＜0．001），生存率也较低（χ2＝19．07、25．34，均P＜0．001）。结论18F?FDG PET／CT显像SUVmax＞2．5的病灶数及MTV均能预测MM患者的无进展生存率及总生存率，较准确地评估其临床预后。 【总页数】4页(44-47)
18F-FDG PET／CT显像SUVmax＞2.5的病灶数及肿瘤代谢体积对多发性骨髓瘤
