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Background and purpose:Positron emission tomography-computed tomography (PET/CT) is playing an increasingly important role in the diagnosis, therapy and follow-up of lymphoma patients. This study aimed to explore clinical and pathological features and bone marrow infiltration status in lymphoma patients with diffused high bone marrow glucose uptake on18F-FDG PET/CT.Methods:It was a retrospective study. Bone marrow infiltration status, pathological and clinical data from 62 cases of pathologically diagnosed lymphoma and diffused high bone marrow glucose uptake were analyzed.Results:Distribution of histopathological subtype in those cases was in accordance with that in previously reported Chinese lymphoma patients. Significant difference was demonstrated in standard uptake value (SUV) between pa-tients with aggressive and indolent histopathological subtypes (8.43vs 5.38,P=0.048), patients with and without B symp-toms (8.30vs 5.72,P=0.033), and patients with and without bone marrow infiltration (8.78vs 6.96,P=0.020). 32 patients were diagnosed as “bone marrow infiltration” by bone marrow biopsy. There was significant difference in histopathologi-cal subtype distribution between patients with and without bone marrow infiltration (P=0.001). In patients with bone marrow infiltration, there were higher proportions of mantle cell lymphoma, nodal marginal zone B cell lymphoma, Burkitt’s lym-phoma and anaplastic large cell lymphoma. In contrast, patients without bone marrow infiltration suffered more from diffuse large B-cell lymphoma, peripheral T cell lymphoma, enteropathic T cell lymphoma and extranodal NK/T-cell lymphoma (nasal type). False positive results in bone marrow glucose uptake may be caused by fever or anemia.Conclusion:Diffused high bone marrow glucose uptake on18F-FDG PET/CT should be evaluated in combination with the uptake values, clinical features and histological subtypes, to minimize the misdiagnosis and to better guide staging and therapy of lymphoma.
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Background and purpose:The clinical relevance of HBV infection with respect to diffuse large B cell lymphoma(DLBCL) patients and immune patterns of T lymphocyte subsets during chemotherapy remains unclear. This study aimed to identify the characteristics of T-cell mediated immunity in DLBCL patients with HBV infection, thereafter, to explore the possible cell-mediated immune mechanisms of HBsAg positive HBV infection on the survival of DLBCL. Methods:A total of 294 newly diagnosed DLBCL patients were enrolled in this cohort study. Four-color flow cytometric method was used to enumerate the absolute number of CD3+, CD4+, CD8+T lymphocytes and the CD4+/CD8+ratio in peripheral blood samples, at the onset of disease, 2-4, 4-6 and 6-12 months after the initiation of chemotherapy, individually. Results:The absolute number of CD3+, CD4+, CD8+T lymphocytes in both groups were similar at the onset of disease;the count of CD4+lymphocytes was lower in HBsAg positive group during 2 to 4 months after the initiation of chemotherapy, compared with that in the HBsAg negative group. During 4 to 12 months after chemotherapy, the CD4+/CD8+ratio in peripheral blood samples was significantly lower in HBsAg positive group. Conclusion:For newly diagnosed DLBCL patients who received chemotherapy, the dynamic nature of cell mediated immune response was characterized as a low counts of CD4+T lymphocyte during the ifrst several cycles of chemother-apy followed by a decreased circulating CD4+/CD8+ratio. Depressions of cell immunity after chemotherapy in HBsAg positive DLBCL patients were greater and prolonged.
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Objective To evaluate a method of fast detection of the hematopoietic progenitor cell (HPC) in peripheral blood samples and explore for an appropriate cutoff value in prediction of adequate CD34+ cell in apheresis concentrate.Methods Peripheral blood samples and apheresis concentrate samples were collected from 27 auto-PBSCT patients receiving chemotherapy plus G-CSF mobilization (chemo group) and 17 patients receiving G-CSF alone (non-chemo group).CD34+ cell counts were determined by flow cytometry according to ISHAGE guideline and HPC counts were detected using Sysmex XE-2100 automatic hemocyte analyzer.The correlation between HPC and CD34+ cell counts in peripheral blood samples and apheresis concentrates were analyzed.Receiver operating characteristic (ROC) curves was used to determine the cutoff value in prediction of adequate CD34+ cell in apheresis concentrate.Results CD34+ cell counts in peripheral blood samples can be estimated by HPC counts (r =0.711,P =0.000,r =0.656,P =0.004).CD34+ cell counts =-0.829+0.648×HPC counts (in chemo group) or 45.033+0.460×HPC counts (in non-chemo group).HPC counts in the peripheral blood of auto-PBSCT patients were highly correlated with the CD34+ cell yield (r =0.602,P =0.001),CD34+ cell counts =1.106+0.046×HPC counts.When HPC in peripheral blood was ≥85/μl,the prediction of adequate CD34+ cells in the yield of apheresis (≥5×106/kg body weight) would have a sensitivity of 78 ％ and a specifity of 82 ％.Conclusion HPC counts in peripheral blood samples in auto-PBSCT patients can be used to determine the optimal time of apheresis and be used as a good marker to predict the stem cell in the yield.
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Objective To explore the technique and effect of selected three-field lymphadenectomy by left thoracotomy in treatment of thoracic middle or lower section esophageal squamous carcinoma. Methods From Jun. 2005 to Mar. 2009, 213 patients with thoracic middle or lower section of esophageal carcinoma received esophagectomy, bilateral mediastinal lymphadenectomy and pleural membrane resection.Group 1 -5, 7 - 12a, 16al, and 19 were performed to dissect abdominal lymph node and extended thoracic and abdominal lymphadenectomy and only lymph node extraction of mesoesophagus in neck field. Results 14197 lymphatic nodes(LN) were detected in 213 case. The average number of resected LN was 66. 65 ±24. 73. The metastatic lymph node was detected in 105 cases. The metastatic rate was 49.05% (105/213).There were 423 metastatic lymph nodes. The lymph nodes metastasis was 2. 97% (423/14197) of all dissected lymphatic nodes. No remnant carcinoma in the upper and lower cutting edge was found in pathological examination. The operation time ranged from 2. 92 ～ 4. 67 ( 3. 37 ± 0. 42) hours. Blood transfusion during perioperative period was 0 ～ 6u ( 1.08 ± 0. 93 ) u. Perioperative plasma transfusion was 0 ～ 1400( 103.77 ± 184. 89) ml. The hospital-time was 14 ～ 39 ( 17.64 ±4. 12) days. There were no anastomotic leakage and recurrent laryngeal nerve injury. One case died from respiratory failure, the mortality was 0. 04% ( 1/213). Conclusion Surgical approach in the management of left thoracotomy in the sixth intercostals could extend resection of chest-field lymph node dissection, decrease neck field lymph node dissection. Abdomen-field lymph node dissection reached selected D3. The selected lymphadenectomy procedure had the advantages of small traumas and few complications.