【作者】 陈琳；

【导师】 田梅；

【作者基本信息】 浙江大学 ， 影像医学与核医学（专业学位）， 2017， 硕士

【摘要】 目的回顾性分析¹⁸F-FDG PET/CT在弥漫大B淋巴瘤患者的诊断作用,探讨病灶SUVmax与病灶体积的关系及免疫组化指标与预后的关系。方法回顾性分析2015年12月至2017年3月浙江大学医学院附属第二医院48例确诊为弥漫大B淋巴瘤的患者。这些患者在化疗前均进行过全身PET/CT检查。采用两样本t检验分析48个病例中共105个病灶在不同淋巴瘤分期之间SUVmax与病灶体积的差异。根据是否为生发中心（GCB）亚型将病例分为A、B两组:A组为GCB阳性组;B组为GCB阴性组。采用多因素logistic回归分析评价弥漫大B淋巴瘤预后的独立危险因素。结果在48例患者中GCB亚型的弥漫大B淋巴瘤有17例,非GCB亚型的弥漫大B淋巴瘤有31例。病灶SUVmax（20.67 ± 11.65）与病灶的体积（36.89 ± 98.22）成正相关（P=0.003）。原发中枢淋巴瘤的病灶体积明显小于高级别（Ⅲ期+Ⅳ期）（P= 0.018）、低级别（Ⅰ期+Ⅱ期）（P=0.010）弥漫大B淋巴瘤。BCL-2阳性（P=0.045,OR = 3.889）是弥漫大B淋巴瘤预后的独立危险因素。原发中枢的病理类型（P=0.058,OR = 3.068）有成为弥漫大B淋巴瘤预后的独立危险因素的趋势。c-myc与弥漫大B淋巴瘤预后之间无明显相关（P=0.670）。结论（1）弥漫大B淋巴瘤病灶体积与其SUVmax成正相关。（2）原发中枢弥漫大B淋巴瘤的病灶体积要显著小于低级别与高级别非原发中枢弥漫大B淋巴瘤的病灶体积。（3）BCL-2阳性是弥漫大B淋巴瘤预后的独立危险因素。18F-FDGPET/CT联合免疫组化指标是评价弥漫大B淋巴瘤的有效手段。更多还原

【Abstract】 ObjectiveThis study aimed at investigating the diagnostic value of ¹⁸F-FDG PET/CT in diffuse large B-cell lymphoma（DLBCL）patients and the correlation between lesion SUVmax and lesion volume,lymphoma stage.MethodsWe retrospectively analyzed 48 DLBCL patients who had been performed PET/CT scans before chemotherapy.Firstly,the lesion volume and the SUVmax of the total 105 lesions in the 48 patients were analyzed.Secondly,the 48 cases were divided into two groups according to the result of germinal center B（GCB）:Group A was GCB positive while Group B was GCB negative.Then the multi-factor logistic analysis was employed to evaluate the independent dangerous prognosis factors of DLBCL.ResultsAmong the 48 patients,17 patients were GCB positive and 31 patients were GCB negative.The lesion SUVmax（20.67±11.65）was positively correlative with the lesion volume（36.89±98.22）（P=0.003）.The lesion volume of primary central nervous system lymphoma was significantly smaller than the lesion volumes of high grade（P=0.018）and low grade DLBCL（P=0.010）.The positive BCL-2was an independent risk factor（P=0.045,OR=3.889）.There was no significant correlation between c-myc and the prognosis（P=0.670）.Conclusion（1）The lesion volume of DLBCL was positively correlated with SUVmax.（2）The lesion volume of primary central nervous system lymphoma was significantly smaller than the volumes of both low grade and high grade DLBCL.（3）The positive BCL-2 pathological index were the independent risk factors.There was no significant correlation between the value of c-myc and the prognosis.¹⁸F-FDG PET/CT combined with immunohistochemical indexes indeed plays an important role in DLBCL assessment.更多还原