Explore The Clinical Value Of SUVmax,SUVsum Of ¹⁸F-FDG PET/CT And Pathological Ki67 Expression In Non-Hodgkin’s Lymphoma

Objective:¹⁸F-FDG PET/CT has important clinical value in the diagnosis and treatment of non-Hodgkin’s lymphoma（NHL）.In order to further explore the clinical significance of maximum standardized uptake value（SUVmax）,sum of the maximum standardized uptake value（SUVsum）and pathological Ki67 expression in NHL,we analyzed the relationship between SUVmax of ¹⁸F-FDG PET/CT and the clinical characteristics of NHL,and explored the differences of SUVmax between different pathological types and the diagnostic value of the combined index SUVmax and Ki67%in the invasiveness of NHL.Furthermore,we explored the value of the SUV of interim ¹⁸F-FDG PET/CT in the prognostic assessment of diffuse large B-cell lymphoma（DLBCL）.Methods:A total of 260 cases of patients of NHL admitted to our hospital from June 2014 to June 2019 were collected,and clinical data including stage,International Prognostic Index（IPI）score,lactate dehydrogenase（LDH）,β2 microglobulin,Ki67%,and baseline SUVmax were collected.For 57 cases of patients of DLBCL who received RCHOP chemotherapy,we collected the baseline and interim ¹⁸F-FDG PET/CT results.Including baseline SUVmax（SUVmax₀）,interim SUVmax(SUVmax_3/4),the sum of the baseline SUVmax（SUVsum₀）and the sum of the interim SUVmax(SUVsum_3/4).We calculated the reduction of SUVmax and SUVsum,and followed up the overall survival（OS）and progression-free survival（PFS）.SPSS26.0 was used to statistically analyze the relationship between SUVmax and the clinical characteristics and pathological types of NHL.The receiver operating characteristic（ROC）curve was drawn to analyze the diagnostic value of the combined index SUVmax and Ki67%in the invasiveness of NHL.And the average values of?SUVmax/SUVmax₀%and?SUVsum/SUVsum₀%were 88.6%and 90.7%as the cutoff values.We used the Kaplan-Meier survival analysis respectively to evaluate the prognosis of the patients of DLBCL.P<0.05 is statistically significant.Result:1.The SUVmax of ¹⁸F-FDG PET/CT was correlated with IPI score,LDH,β2microglobulin of NHL,and positively correlated with Ki67%（P<0.01）,There was no significant difference in SUVmax among the groups with sex,age,stage and with or without exonodal invasion（P>0.05）.2.Among the 260 cases of NHL,the median SUVmax of the anaplastic large cell lymphoma（ALCL）was the highest（17.85）and that of DLBCL was 16.65,with the widest distribution range ranging from 0.7 to 53.5.The SUVmax of aggressive lymphoma（AL）was higher than that of indolent lymphoma（IL）（P<0.05）.The SUVmax of DLBCL was significantly higher than that of mantle cell lymphoma（MCL）（P<0.01）.There was no significant difference in SUVmax between high grade follicular lymphoma（FL-High）and low grade follicular lymphoma（FL-Low）（P>0.05）.In addition,in the range distribution of SUVmax in NHL,there was a large overlap among different pathological types when SUVmax<10.3.The area under the curve（AUC）of Ki67%was 0.88,the sensitivity was 85.71%,and the specificity was 78.3%.The AUC of SUVmax alone was 0.754,the sensitivity was68.83%,and the specificity was 78.3%.The AUC of the combined index of SUVmax and Ki67%was 0.911,the sensitivity was 81.82%,and the specificity was 86.79%.The combined index of SUVmax and Ki67%was better than that of the SUVmax（P<0.01）.4.PFS and OS with SUVmax reduction≥88.6%were better than the patients of DLBCL with SUVmax reduction<88.6%,PFS with SUVsum reduction≥90.7%was better than those with SUVsum reduction<90.7%（P<0.05）.Conclusion:1.The SUVmax of ¹⁸F-FDG PET/CT was correlated with IPI score,LDH,β2 mic roglobulin of NHL,and positively correlated with Ki67%;2.The SUVmax of ¹⁸F-FDG PET/CT cannot distinguish pathological stypes of NHL accurately.Using the combined index of SUVmax and Ki67%to evaluate the invasiveness of NHL is more advantageous than using SUVmax alone;3.The reduction ratio of semi-quantitative SUVmax and SUVsum in interim ¹⁸F-FDG PET/CT is helpful to predict the prognosis of the patients of DLBCL.