| Background and objective:Lymphoma is a malignant tumor originating from lymph node or extranodal lymphoid tissue,which is divided into two types: non-Hodgkin lymphoma(NHL),and Hodgkin lymphoma(HL).NHL is classified into indolent lymphoma(i NHL),aggressive lymphoma and highly aggressive lymphoma according to the invasiveness.i NHL is more common in patients with indolent B-cell non-Hodgkin’s lymphoma(B-i NHL).PET/CT has the advantages of high sensitivity and specificity.It is widely used in staging and therapeutic evaluation of lymphoma,but it is still unclear whether PET/CT can predict the prognosis of patients with B-i NHL before treatment,which still needs to be confirmed by a large number of studies.18F-Fluorodeoxyglucose(18F-FDG)is the most widely used in PET/CT.The maximum standardized uptake value(SUVmax)is the most commonly used metabolic parameter of 18F-FDG in PET/CT,which is a semi-quantitative parameter based on the degree of tumor metabolism.The value of SUVmax in the prognosis of B-i NHL is not clear at present.Therefore,it is of great clinical significance to investigate the prognostic value of SUVmax,clinical stage,number of extranodal lesions,bone marrow invasion,IPI score and other clinical factors in patients with B-i NHL before treatment.Methods:This clinical data were retrospectively analyzed of 132 patients with B-i NHL from November 2011 to October 2018 with newly diagnosed and pretreatment PET-CT who were admitted to Department of Hematology,the First Hospital of Jilin University,Including pathological types,clinical stage and so on.The follow-up time of 132 patients was March 1,2019.Data of non-normal distribution were analyzed by Mann-Whitney U rank sum test.The optimal SUVmax was obtained by using the receiver operating characteristic(ROC)curve,and the area under the curve(AUC)was calculated.Kaplan-Meier method was used for survival analysis,Log-Rank testwas used for comparison among groups,and multivariate analysis was performed using COX proportional hazards model.Results:1.The 132 B-i NHL patients’ median of SUVmax was 6.6(1.8-25.4),FL 54 cases,which median of SUVmax was 8.0(3.6-20.3),non-FL 78 cases,which median of SUVmax was 5.1(1.8-25.4)(P=0.001).According to SUVmax,132 B-i NHL patients were divided into high SUVmax group(SUVmax > 7.25)and low SUVmax group(SUVmax ≤ 7.25),52 cases(39.4%)and 80 cases(60.6%),respectively.2.Evaluation of prognosis showed that 3-year estimated progression free survival(PFS)for high SUVmax group and low SUVmax group were 61.9% and86.8%,respectively(P<0.05),while 3-year estimated overall survival(OS)were82.0% and 98.7%(P<0.05).3.Univariate analysis and multivariate analysis showed that SUVmax>7.25 was independent prognostic risk factors of PFS and OS(P<0.05).4.9 patients in high SUVmax group and 1 in low SUVmax group died,showing a significant difference in the morality rate between the two groups(9/52 vs 1/80,17.3% vs 1.25%,P<0.001).Conclusions:1.The median PET/CT SUVmax was 6.6 in 132 patients with indolent B-cell non-Hodgkin’s lymphoma,the median SUVmax of FL(8.0)was higher than the overall,and non-FL(5.1)was lower than the overall.2.Our study indicated,PET/CT SUVmax 7.25 was the prognostic cut-off value of 132 patients with indolent B-cell non-Hodgkin’s lymphoma.3.PET-CT SUVmax in indolent B-cell non-Hodgkin’s lymphoma was higher than prognostic cut-off value,the mortality rate increased.4.PET-CT SUVmax was independent prognostic factor of PFS、OS in indolent B-cell non-Hodgkin’s lymphoma. |
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