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目的:探讨在淋巴瘤治疗中期18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像(fluorine-18 fluorodeoxyglucose positron emission tomography,18F-FDP PET/CT)检查的临床应用价值。方法:回顾分析43例淋巴瘤患者治疗中期18F-FDPPET/CT检测淋巴结和结外病变的结果,并与同期CT、B超影像结果进行比较,并结合淋巴结、骨髓活检及生化结果,评价其对早期临床疗效的评价和对预后的预测价值。结果:治疗中期18F-FDP PET/CT共检测15例有残留病灶,此15例临床均未获得完全缓解。同期CT和B超检查29例共32处有残留肿块,除其中同时伴PET阳性的有9例全部复发,另20例得到完全缓解(HD5例,NHL15例);另有8例PET和CT或B超均为阴性,期中2例复发;此外还对6例PET/CT显示阴性但CT、B超检查显示阳性患者的浅表淋巴结进行了2次活检,病理结果均显示为非淋巴瘤组织。比例风险模型(COX)分析显示中期PET阳性为疾病复发或进展的独立预后不良因素(P<0.01)。结论:PET/CT对肿块性质判定较传统影像有显著的优势,治疗中期PET/CT检查对早中期疗效判断和临床预后有显著的临床意义。
Objective: To investigate the clinical value of 18 F-FDG PET / CT in the mid-term of lymphoma treatment. Methods: A retrospective analysis of 43 cases of lymphoma in the treatment of metaphase 18F-FDPPET / CT detection of lymph nodes and extranodal disease results, and with the same period of CT, B ultrasound imaging results, combined with lymph nodes, bone marrow biopsy and biochemical results, evaluation of the Evaluation of early clinical efficacy and prediction of prognosis. Results: In the middle of treatment, 15 cases had residual lesions detected by 18F-FDP PET / CT, and none of the 15 cases achieved complete remission. CT and B ultrasound over the same period in 29 cases, a total of 32 residual lumps, with the exception of which simultaneously with PET positive all the recurrence in 9 cases, the other 20 cases were completely relieved (HD5 cases, NHL 15 cases); another 8 cases of PET and CT or B ultrasound were both negative, 2 cases of recurrence; In addition, 6 cases of PET / CT showed negative, but CT, B-ultrasound showed positive in patients with superficial lymph nodes biopsy, the pathological findings were non-lymphoma tissue. Proportional risk model (COX) analysis showed that medium-term PET positive was an independent prognostic factor for disease recurrence or progression (P <0.01). Conclusion: PET / CT has a significant advantage over the traditional imaging in determining the quality of the mass. The treatment of mid-term PET / CT has a significant clinical significance in the judgment of early and mid-term efficacy and clinical prognosis.