18F-FDG PET/CT预测淋巴瘤患者CAR-T细胞治疗后短期疗效的价值研究
Study on the value of 18F-FDG PET/CT in predicting short-term efficacy of CAR-T cell treatment in lymphoma patients
胡静 1代岳 2徐凯2
作者信息
- 1. 徐州医科大学医学影像学院,江苏 徐州 221006
- 2. 徐州医科大学医学影像学院,江苏 徐州 221006;徐州医科大学附属医院影像科,江苏 徐州 221006
- 折叠
摘要
目的 探讨18F-氟代脱氧葡萄糖(18F-FDG)PET/CT在预测淋巴瘤患者接受嵌合抗原受体(CAR)-T细胞治疗后短期疗效的价值.方法 回顾性分析30例淋巴瘤患者CAR-T细胞治疗前的18F-FDG PET/CT成像参数[最大标准化摄取值(SUVmax)、总代谢肿瘤体积(TMTV)、病灶糖酵解总量(TLG)和最大病灶的最大直径(Dmax)]及血清学指标[β2-微球蛋白(β2-MG)和乳酸脱氢酶(LDH)].CAR-T细胞治疗后4周评价治疗效果,分为完全缓解(CR)组和非CR组,对比2组患者治疗前PET/CT参数差异,使用二元logistic回归分析获得评价短期疗效的独立预测因子,通过受试者工作特征(ROC)曲线确定最佳截断值.结果 30例淋巴瘤患者经CAR-T细胞治疗后4周CR 14例,非CR 16例,组间SUVmax、TLG、Dmax及β2-MG差异有统计学意义(P<0.05).SUVmax是评价CAR-T短期疗效的独立预测因素,最佳阈值为12.5,曲线下面积(AUC)为 0.839,敏感度和特异度分别为 87.5%和 78.6%.结论 基线18F-FDG PET/CT代谢参数可用来预测接受CAR-T细胞治疗的淋巴瘤患者短期疗效,SUVmax是评估短期疗效的独立预测指标.
Abstract
Objective To explore the value of 18F-fluorodeoxyglucose(18F-FDG)PET/CT in predicting the short-term efficacy of chimeric antigen receptor(CAR)-T cell treatment in lymphoma patients.Methods The 18F-FDG PET/CT parameters[maximum standardized uptake value(SUVmax),total metabolic tumor volume(TMTV),total lesion glycolysis(TLG),and the maximum diam-eter of the maximum lesion(Dmax)]and serological indexes[β2-microglobulin(β2-MG)and lactate dehydrogenase(LDH)]of 30 lym-phoma patients before CAR-T cell treatment were analyzed retrospectively.The treatment efficacy was evaluated 4 weeks after CAR-T cell treatment,and all patients were divided into complete remission(CR)group and non-CR group to compare the differences in pre-treatment PET/CT parameters between the two groups.Binary logistic regression analysis was used to obtain the independent predictive factors for evaluating the short-term efficacy,and the optimal thresholds was determined via receiver operating characteristic(ROC)curve.Results Of 30 lymphoma patients 4 weeks after CAR-T cell treatment,there were 14 cases with CR and 16 cases with non-CR.There were statistical differences in SUVmax,TLG,Dmax and β2-MG between the two groups(P<0.05).SUVmax was the independent predictor for evaluating the short-term efficacy of CAR-T,with an optimal threshold of 12.5,an area under the curve(AUC)of 0.839,and the sensitivity and specificity was 87.5%and 78.6%,respectively.Conclusion Baseline 18F-FDG PET/CT parameters can be used to predict the short-term efficacy in lymphoma patients receiving CAR-T cell treatment,and SUVmax is an independent predictor for assessing short-term efficacy.
关键词
淋巴瘤/嵌合抗原受体-T/18F-氟代脱氧葡萄糖/正电子发射断层显像/计算机体层成像/短期疗效评价Key words
lymphoma/chimeric antigen receptor-T/18F-flu-orodeoxyglucose/positron emission tomography/computed tomo-graphy/short-term efficacy evaluation引用本文复制引用
出版年
2025
NETL
NSTL
万方数据