中国癌症杂志2025，Vol.35Issue(6)：531-542,12.DOI:10.19401/j.cnki.1007-3639.2025.06.002
弥漫性大B细胞淋巴瘤基因变异特征与18F-FDG PET/CT SUVmax的关系解析及其临床意义
The research on the association between genetic alterations of DLBCLs and 18F-FDG PET/CT SUVmax and their clinical significance
摘要
Abstract
Background and purpose:Next generation sequencing-identified genetic alterations of diffuse large B cell lymphoma(DLBCL)and baseline SUVmax detected by 18F-FDG PET/CT were correlated with patients'prognosis.However,their relationship and the associations with R-CHOP response of DLBCL are still unclear.This study aimed to analyze the association bewteen genetic alterations and 18F-FDG PET/CT SUVmax and their correlations with clinicopathological characteristics and R-CHOP response of DLBCL.Methods:A total of 225 cases of primary DLBCL detected by next generation sequencing using 481 lymphoma gene panel and examined by 18F-FDG PET/CT before treatment between 2022 and 2023 were collected.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(Ethical No.:050432-4-2307E)and acquired the informed consent of the patients.The translocations of BCL2,BCL6 and MYC were identified by fluorescence in situ hybridization.The clinicopathological characteristics and the PET/CT scan after R-CHOP chemotherapy were collected.Results:Finally,191 patients were enrolled in this study.The frequency of MYD88 mutation,TP53 mutation,copy number variations of CDKN2A/2B,CD79B mutation in the 191 DLBCL patients were 24.6%,27.2%,32.5%and 16.8%,respectively.The range of baseline SUVmax was 5.10-63.10(24.44±10.70,median 22.80).The baseline SUVmax of MYD88L265P DLBCL was significantly higher than that of MYD88 wild type(P=0.039).There were no significant associations of SUVmax with other gene alterations including TP53 mutation,CDKN2A/B loss,CD79B mutation,KMT2D mutation,TNFAIP3 mutation,B2M mutation,EZH2 mutation,BTG1/2 mutation,CREBBP mutation,gene translocations of MYC,BCL2 and BCL6.The higher SUVmax before treatment was correlated with higher serum lactate dehydrogenase(LDH)level(P=0.012)and non-germinal center B-cell-like(non-GCB)DLBCL(P=0.040).However,there was no significant association of SUVmax with R-CHOP response(P=0.714).TP53 mutation was significantly associated with the poor response of R-CHOP(P=0.001)and was an independent predictor of non-complete metabolic response(non-CMR).TP53 mutation combined with Ann Arbor stage,International Prognostic Index(IPI)score and serum LDH level could better predict R-CHOP response than each factor alone.Conclusion:MYD88L265P DLBCL had higher baseline 18F-FDG PET/CT SUVmax.The baseline SUVmax was not associated with R-CHOP response.However,TP53 mutation was significantly correlated with poor response of R-CHOP in DLBCL patients.TP53 mutation combined with clinicopathological characteristics could better predict R-CHOP response.The associations of gene alterations and SUVmax with prognosis of DLBCL patients needed to be explored in the future.关键词
弥漫性大B细胞淋巴瘤/基因变异特征/18F-FDG PET/CT/SUVmax/R-CHOP/治疗反应Key words
Diffuse large B cell lymphoma/Genetic alterations/18F-FDG PET/CT/SUVmax/R-CHOP/Therapeutic response分类
医药卫生引用本文复制引用
田田,周晓燕,陈晨,魏然,包龙龙,顾丙新,张群岭,曹军宁,于宝华,李小秋..弥漫性大B细胞淋巴瘤基因变异特征与18F-FDG PET/CT SUVmax的关系解析及其临床意义[J].中国癌症杂志,2025,35(6):531-542,12.基金项目
上海市协同创新集群(2019CXJQ03) （2019CXJQ03）
上海市科学技术委员会"科技创新行动计划"医学创新研究专项(20Z11900300). Shanghai Collaborative Innovation Cluster(2019CXJQ03) （20Z11900300）
Special Program for Medical Innovation Research(Science and Technology Innovation Action Plan,Shanghai Municipal Science and Technology Commission)(20Z11900300). （Science and Technology Innovation Action Plan,Shanghai Municipal Science and Technology Commission）
