| 赵梅莘,张卫方.从孤立性骨浆细胞瘤到多发性骨髓瘤:18F-FDG PET/CT早期预测[J].中国医学影像技术,2019,35(12):1861~1865 |
| 从孤立性骨浆细胞瘤到多发性骨髓瘤:18F-FDG PET/CT早期预测 |
| From solitary bone plasmacytoma to multiple myeloma: Early predicting with 18F-FDG PET/CT |
| 投稿时间：2019-05-14 修订日期：2019-10-08 |
| DOI：10.13929/j.1003-3289.201905116 |
| 中文关键词: 孤立性骨浆细胞瘤 多发性骨髓瘤 放射性核素显像 氟脱氧葡萄糖18F |
| 英文关键词:solitary bone plasmacytoma multiple myeloma radionuclide imaging Fluorodeoxyglucose F18 |
| 基金项目:国家重点研发计划（A70497-05）。 |
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| 中文摘要: |
| 目的 探讨18F-FDG PET/CT显像及临床、病理因素对早期预测孤立性骨浆细胞瘤（SBP）进展为多发性骨髓瘤（MM）的价值。方法 收集因单发骨病灶接受18F-FDG PET/CT检查并经病理证实为SBP的患者20例，对其进行随访，以进展为活动性MM为临床结局，将患者分为进展组及未进展组。对比分析2组初诊时血清免疫球蛋白固定电泳、血清M蛋白、血清游离轻链检测结果及18F-FDG PET/CT图像病灶最大标准摄取值（SUVmax）、病灶固定阈值为40% SUVmax时的肿瘤代谢体积（MTV）、糖酵解总量（TLG）的差异。结果 20例SBP患者中，8例进展为MM（进展组），12例未进展（未进展组）。进展组病灶MTV明显高于非进展组（Z=-2.807，P=0.031），且2组血清免疫球蛋白固定电泳、血清M蛋白、血清游离轻链检测结果、肿瘤细胞Ki-67表达阳性率及病灶SUVmax、TLG差异均无统计学意义（P均>0.05）。结论 高MTV水平是SBP进展为MM的因素之一。对高MTV水平SBP患者需给予更多临床关注及干预，以尽量延缓肿瘤向MM进展。 |
| 英文摘要: |
| Objective To investigate the predictive value of 18F-FDG-PET/CT imaging and other clinicopathological factors for prognosis of solitary bone plasmacytoma (SBP) to multiple myeloma (MM). Methods Twenty patients underwent 18F-FDG PET/CT. All patients were pathologically confirmed as SBP and followed-up. Taken progression to MM as a clinical outcome,the patients were divided into progressive group and non-progressive group. Immunoglobulin fixed electrophoresis, M protein, positive rate of free light chain in blood, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in PET/CT images were analyzed between the two groups. Results Eight patients developed into MM (progressive group), whereas the other 12 patients did not (non-progressive group). MTV in progressive group was higher than that in non-progressive group (Z=-2.807, P=0.031). There was no significant difference of serum immunoglobulin electrophoresis, M protein, free light chain level, Ki67 positive rate of tumor cells, SUVmax nor TLG between the two groups (all P>0.05). Conclusion High MTV level is a poor prognostic factor for the progression of SBP to MM. Patients with high MTV level may need more clinical attention and active intervention to delay progression of SBP to multiple myeloma as far as possible. |
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