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Prognostic value of 18F-FDG PET/CT and C-MYC gene rearrangement on chemotherapy in patients with diffuse large B-cell lymphoma / 中华核医学与分子影像杂志
Chinese Journal of Nuclear Medicine and Molecular Imaging ; (6): 593-597, 2018.
Article in Chinese | WPRIM | ID: wpr-708917
ABSTRACT
Objective To evaluate the prognostic value of the maximum standardized uptake value decrease proportion (△SUVmax%) on 18F-fluorodeoxyglucose (FDG) PET/CT imaging and C-MYC gene in diffuse large B cell lymphoma (DLBCL),and to find the optimal time of PET/CT imaging.Methods From September 2010 to February 2016,171 patients (87 males,84 females,average age(50.66±2.56) years)with pathologically confirmed DLBCL were analyzed.18F-FDG PET/CT were performed before and after different courses of chemotherapy (60 patients in early phase which means 1 and 2 courses;55 patients in medium phase,3 and 4 courses;56 patients in late phase,5 and 6 courses).The region of interest (ROI) was drawn and the △SUVmax% was calculated.Patients were evaluated with Deauville 5-point scale.Fluorescence in situ hybridization (FISH) was employed to detect C-MYC gene.Patients were followed up for 6-71 months,and progression-free survival (PFS) was calculated.x2 test,one-way analysis of variance,Kaplan-Meier analysis and Spearman correlation analysis were used to analyze the data.Results There were 42 C-MYC gene rearrangement of 171 DLBCL patients.Age,Ann Arbor stage,international prognostic index (IPI) score,serum lactate dehydrogenase (LDH) level and therapeutic response were different between patients with C-MYC gene rearrangement and those without rearrangement (x26.139-98.339,all P<0.05).The optimum cutoff values of the △SUVmax% were 62.5%,87.0% and 92.0% respectively in the early,medium and late phases of chemotherapy.Patients with △SUVmax% ≥≥ 62.5%,≥ 87.0% or ≥ 92.0% and normal C-MYC gene showed longer PFS (x2 values21.983-61.899,all P<0.001).The △SUVmax% was negatively correlated with C-MYC gene rearrangement (rs =-0.801,P < 0.001).Significant differences were found in △SUVmax% (F=6.509,P<0.01) and Deauville 5-point scale (F=19.897,P<0.001) among patients in early,medium and late phases.No Significant differences were shown between medium and late phases (P>0.05).Conclusion △SUVmax% in the different phases of chemotherapy and C-MYC gene rearrangemeut have better values for predicting the prognosis of DLBCL,and 18F-FDG PET/CT imaging should be performed between 1 course and 4 courses of chemotherapy.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Nuclear Medicine and Molecular Imaging Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Nuclear Medicine and Molecular Imaging Year: 2018 Type: Article