诊断学理论与实践2025，Vol.24Issue(2)：178-186,9.DOI:10.16150/j.1671-2870.2025.02.009
滤泡合并弥漫大B细胞淋巴瘤的PET/CT特征及其联合IPI在预后评估中的价值
Prognostic value of PET/CT characteristics and combined IPI in follicular lymphoma and diffuse large B-cell lymphoma
摘要
Abstract
Objective The international prognostic index(IPI)has limited ability to distinguish risk levels in patients with follicular lymphoma and diffuse large B-cell lymphoma(FL/DLBCL).This study aims to investigate the diffe-rences in imaging features between FL/DLBCL and DLBCL,and to integrate baseline PET/CT characteristics with clinical parameters to improve the prognostic efficiency of the IPI in FL/DLBCL patients.Methods A total of 65 consecutive patients with pathologically confirmed FL/DLBCL treated at our hospital between January 2015 and January 2022 were col-lected(follow-up duration:2.4-113.0 months),and a 1∶1 matched group of patients diagnosed with DLBCL during the same period was selected(follow-up duration:2.9-91.6 months).PET/CT features and survival differences between the two groups were compared.Cox regression analysis was used to identify independent prognostic factors for progression-free sur-vival(PFS)in FL/DLBCL patients,which were incorporated into a nomogram.The predictive value of the model was evalua-ted using the concordance index(C-index)and receiver operating characteristic(ROC)curves.Results Compared with DLBCL,FL/DLBCL patients had a greater largest distance between two lesions(Dmax)on PET/CT images(55.07 vs.33.82,P=0.031)and a greater number of total lesions throughout the body(7 vs.4,P=0.002).The IPI could only distinguish between low-risk and non-low-risk FL/DLBCL groups(P=0.010),but failed to identify patients at high risk of progression(P=0.743).Integrated analysis of PET/CT imaging features and clinical parameters showed that Dmax(HR=3.151,95%CI:1.253-7.922,P=0.015)and IPI(HR=3.285,95%CI:1.208-8.932,P=0.020)were independent prognostic factors for PFS in FL/DLBCL patients.Based on this,a nomogram was constructed,with a C-index of 0.701.All three global tests(likeli-hood ratio test,Wald test,and score test)showed high statistical significance(P<0.001).Conclusion FL/DLBCL exhibits more disseminated characteristics on PET/CT images compared to DLBCL.Additionally,Dmax is a highly promising para-meter for prognostic evaluation in FL/DLBCL,and the nomogram constructed based on Dmax and IPI demonstrates excel-lent discriminatory ability and predictive accuracy in predicting FL/DLBCL survival outcomes.关键词
国际预后指数/PET/CT/弥漫大B细胞淋巴瘤/滤泡性淋巴瘤/预后Key words
International prognostic index/PET/CT/Diffuse large B-cell lymphoma/Follicular lymphoma/Prognosis分类
医药卫生引用本文复制引用
李卓含,黄新韵,郭睿,易红梅,许彭鹏,武志芳,李彪..滤泡合并弥漫大B细胞淋巴瘤的PET/CT特征及其联合IPI在预后评估中的价值[J].诊断学理论与实践,2025,24(2):178-186,9.基金项目
上海申康医院发展中心临床科技创新项目(SHDC22023201) （SHDC22023201）
