ABSTRACT
Objective:To explore the role of 18F-fluorodeoxyglucose (FDG) PET/CT in early detection of therapy-associated cardiotoxicity (TACT) in lymphoma patients and to analyze the diagnostic efficacy of different evaluation criteria. Methods:Consecutive patients between November 2009 to October 2018 in Peking University Cancer Hospital were retrospectively enrolled. All patients underwent standard chemotherapy. Myocardial uptake of 18F-FDG pre- and post-treatment were analyzed by visual interpretation and semi-quantitative (maximum standardized uptake value, SUV max) methods. The value of pre-treatment SUV max-heart -post-treatment SUV max-heart (ΔSUV max), %ΔSUV max, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background(left gluteal muscle) ratios were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cut-off values of those PET/CT imaging criteria for evaluating early TACT of lymphoma, taking electrocardiogram (ECG) positive as the end point. Independent-sample t test and χ2 test were performed. Results:A total of 274 patients (median age was 36-year old), with the male-to-female ratio of 1.85∶1, were included, and 78.1%(214/274) of them had non-Hodgkin′s lymphoma (NHL). After treatment, 55.1%(151/274)of the patients had high myocardial uptake of 18F-FDG (compared with liver uptake), 20.4%(56/274) of them had moderate myocardial uptake (between liver uptake and blood-pool uptake), and 24.5%(67/274) were with equal uptake (less than blood-pool uptake). There were significant differences in myocardial uptake between ECG-positive group ( n=71) and ECG-negative group ( n=203) ( SUV max: 7.77±4.06 vs 5.91±3.04; t=4.045, P<0.01). ROC curves showed that optimal thresholds of post-treatment SUV max-heart, Δ SUV max-heart, %ΔSUV max-heart, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background ratios were 9.4, 4.8, 1.4, 5.0, 2.3, 7.0 respectively. The corresponding areas under the curves (AUC) were 0.653, 0.637, 0.612, 0.655, 0.649 and 0.650, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of post-treatment SUV max-heart/SUV max-background ratio were 40.85%(29/71), 82.76%(168/203), 45.31%(29/64), 80.00%(168/210) and 71.90%(197/274). Conclusion:18F-FDG PET/CT can early detect TACT in patients with lymphoma, and if using 7.0 as the threshold of post-treatment SUV max-heart/SUV max- background ratio, the specificity and negative predictive value of 18F-FDG PET/CT for early prediction of TACT are up to 80%.
ABSTRACT
Objective@#To analyze the characteristics of changes in serum cholesterol level in sepsis patients, and to explore its correlation with prognosis.@*Methods@#A retrospective analysis was conducted. Two hundred and six patients with sepsis admitted in the Third People′s Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group), and 206 patients without sepsis hospitalized in the same period were served as control group. The basic clinical data of the two groups were collected, and the results of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared. The patients with sepsis were divided into death group and survival group, and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis.@*Results@#Compared with control group, the levels of serum TC [(2.49 ± 1.14) mmol/L vs. (3.40 ± 1.26) mmol/L, t=6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs. (2.49 ± 0.81) mmol/L, t=5.532] in observation group were significantly lower (P<0.05), and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs. (2.10 ± 0.72) mmo/L, t=0.940, P>0.05]. In observation group, the patients in death group (85 cases) were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs. (62.5 ± 6.0) years, t=4.565], serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs. (165.4 ± 35.6) μmol/L, t=5.420], and the levels of serum TC [(2.15 ± 0.59) mmol/L vs. (2.89 ± 1.02) mmol/L, t= 5.475], HDL-C [(1.40 ± 0.42) mmol/L vs. (1.94 ± 0.52) mmol/L, t=4.856] and LDL-C [(1.73 ± 0.56) mmol/L vs. (1.97 ± 0.72) mmol/L, t=4.261] were significantly lower than those of survival group (P<0.05). Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.256, 95% CI 1.006 -1.056, P=0.012), and TC was the protective factor for the prognosis of sepsispatients (OR=-0.758, 95%CI 0.579-0.867, P=0.014).@*Conclusions@#The levels of TC, HDL-C in sepsis patients are significantly lowered, and the levels of TC, HDL-C, LDL-C in death group are significantly lower than those in survival group. TC may be used as a clinical indicator to assess the outcome of sepsis patients.
ABSTRACT
Objective To analyze the characteristics of changes in serum cholesterol level in sepsis patients,and to explore its correlation with prognosis.Methods A retrospective analysis was conducted.Two hundred and six patients with sepsis admitted in the Third People's Hospital of Dalian from February 2015 to February 2019 were enrolled (observation group),and 206 patients without sepsis hospitalized in the same period were served as control group.The basic clinical data of the two groups were collected,and the results of total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C) and biochemical parameters were compared.The patients with sepsis were divided into death group and survival group,and risk factors influencing the prognosis of patients with sepsis were analyzed with Logistic regression analysis.Results Compared with control group,the levels of serum TC [(2.49 ± 1.14) mmoFL vs.(3.40 ± 1.26) mmoFL,t =6.240] and HDL-C [(1.66 ± 0.89) mmol/L vs.(2.49 ± 0.81) mmol/L,t =5.532] in observation group were significantly lower (P ＜ 0.05),and that of LDL-C showed no statistically significant difference [(1.96 ± 0.91) mmol/L vs.(2.10 ± 0.72) mmo/L,t =0.940,P＞0.05].In observation group,the patients in death group (85 cases)were older than those of the survival group (121 cases)[(75.6 ± 8.6) years vs.(62.5 ± 6.0) years,t =4.565],serum creatinine (SCr) was higher than that of survival group [(246.2 ± 34.6) μmol/L vs.(165.4 ± 35.6)μ mol/L,t =5.420],and the levels of serum TC [(2.15 ± 0.59) mmol/L vs.(2.89 ± 1.02) mmol/L,t =5.475],HDL-C [(1.40 ± 0.42) mmol/L vs.(1.94 ± 0.52) mmol/L,t =4.856] and LDL-C [(1.73 ± 0.56)mmol/L vs.(1.97 ± 0.72) mmol/L,t =4.261] were significantly lower than those of survival group (P＜0.05).Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR =1.256,95％ CI 1.006-1.056,P=0.012),and TC was the protective factor for the prognosis of sepsispatients (OR =-0.758,95％CI 0.579-0.867,P =0.014).Conclusions The levels of TC,HDL-C in sepsis patients are significantly lowered,and the levels of TC,HDL-C,LDL-C in death group are significantly lower than those in survival group.TC may be used as a clinical indicator to assess the outcome of sepsis patients.