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Objective To explore the differences in the prognosis of patients with different immunophenotypes gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) who received different treatment strategies.Methods From March 2006 to January 2016,at Nanfang Hospital,Southern Medical University in Guangzhou,the clinical data of 99 patients with pathologically confirmed GI-DLBCL were retrospectively analyzed.According to treatment strategies,patients were divided into chemotherapy alone group and combination of surgery and chemotherapy group.According to immunophenotypes,patients were divided into germinal center B-cell-like (GCB) type and non-GCB type.The two-year progression-free survival (PFS) rate and overall survival (OS) rate were evaluated.Kaplan-Meier analysis,log-rank test and Cox regression were performed for statistical analysis.Results Among the 99 patients with GI-DLBCL,51 patients were treated with chemotherapy alone,and 48 patients were treated with combination of surgery and chemotherapy.Forty-one cases were GCB phenotype and 40 cases were non-GCB phenotype.The median follow-up time was 25 months.The two-year PFS and OS rates were 70.9％ and 89.5％,respectively.The two-year PFS and OS rates of chemotherapy alone group were 63.6％ and 85.0％,respectively;both were lower than those of combination of surgery and chemotherapy group (79.4％ and 94.7％),and the differences were statistically significant (x2 =4.232,P =0.040 and x2 =4.260,P =0.039).The two-year PFS and OS rates of GCB group were 68.8％ and 93.9％,respectively.And the two-year PFS and OS rates of non-GCB group were 73.2％ and 85.6％,respectively.There were no statistically significant differences between these two groups (both P ＞ 0.05).Among 41 patients with GCB type,25 were treated with combination of surgery and chemotherapy and 16 were treated with chemotherapy alone.The two-year PFS rate of patients treated with combination of surgery and chemotherapy (83.1％) was higher than that of patients treated with chemotherapy alone (49.2％),and the difference was statistically significant (x2 =5.627,P =0.018).The results of multivariate analysis indicated that treatment strategy was not an independent prognostic factor for all the enrolled patients and in patients with GCB type (all P ＞ 0.05).Conclusions Immunophenotypes may lack evaluation value of prognosis in patients with GI-DLBCL.Although among all the enrolled patients and patients with GCB type,the prognosis of patients treated with combination of surgery and chemotherapy is better than that of patients treated with chemotherapy alone,treatment strategy is not an independent prognostic factor.Multi-factors should be evaluated before selection of treatment strategy.
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Objective To explore whether the prognostic efficiency of international prognostic index (IPI) can be further improved by interim 18F-fluorodeoxyglucose (FDG) PET/CT.Methods A total of 185 patients (116 males,69 females;average age 49 years) with pathologically confirmed diffuse large Bcell lymphoma (DLBCL) from January 2004 to January 2014 were enrolled in this retrospective study.The risk was classified by IPI (0-2 was considered as low risk,3-5 was considered as high risk) and all patients underwent 18F-FDG PET/CT scan before and after 4 cycles of immunochemotherapy.Based on interim 18 F-FDG PET/CT imaging,5-point Deauville score was used to reclassify DLBCL patient into negative group and positive group,and the interpretations were evaluated for 2-year progression-free survival (PFS) and overall survival (OS) rates.Kaplan-Meier analysis,log-rank test and Cox regression were used for data analysis.Results With a median follow-up of 27 (2-146) months,the 2-year PFS and OS rates were 60％(111/185) and 81％(150/185),respectively.A total of 114 patients were included in the low-risk group and 71 patients were in the high-risk group.Both 2-year PFS rates and OS rates between the 2 groups were statistically different:72％(82/114) vs 37％(26/71),x2=20.86,P＜0.01;90％(103/114) vs 63％(45/71),x2=13.39,P＜0.01.The interim PET/CT showed 113 patients with negative results and 72 patients with positive results,whose 2-year PFS rates and OS rates were also statistically different:82％ (93/113) vs 24％(17/72),x2 =66.66,P＜0.01;90％(102/113) vs 51％(37/72),x2 =33.11,P＜0.01.In the low-risk group,85 patients were PET-negative and 29 patients were PET-positive.The 2-year PFS rates were 88％ (75/85) and 31％(9/29),respectively (x2 =35.52,P＜0.01).The 2-year OS rates were 96％ (82/85) and 66％(19/29),respectively (x2 =11.88,P＜0.01).In the high-risk group,28 patients were PET-negative and 43 patients were PET-positive.The 2-year PFS and OS rates were 64％(18/28) vs 19％(8/43;x2 =17.33,P＜0.01) and 86％(24/28) vs 49％(21/43;x2=9.95,P＜0.01),respectively.Conclusions Both IPI and interim 18F-FDG PET/CT have the prognostic value for patients with DLBCL.Interim 18F-FDG PET/CT can improve the prognostic efficiency of IPI.
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Objective To explore the clinical value of 18F-FDG PET/CT in the diagnosis of cardiac neoplasm.Methods Between January 2007 and December 2011,18F-FDG PET/CT was performed in 8649 patients in our hospital,and 14 (0.16％ ; 11 males,3 females,average age 46.9 (35-68) years) patients were diagnosed with cardiac neoplasm.18F-FDG PET/CT data of those 14 patients were retrospectively analyzed.Final diagnoses were confirmed by either histopathology (n =5) or follow-up (n =9).Results Accurate tumor localization and diagnoses were made by 18 F-FDG PET/CT in all 14 patients.Among them,13 were malignant (2(14.3％,2/14) primary and 11(78.6％,11/14) metastatic tumors (8 HCC,2 lung cancer,1 esophageal cancer) ; SUVmax 3.2-10.7) and 1 (7.1％,1/14) was benign (myxoma).Conclusion 18F-FDG PET/CT is useful for the detection and staging of primary malignant and metastatic cardiac neoplasms.