Evaluation Of Prognosis Of Non-Hodgkin’s Lymphoma By Baseline ¹⁸F-FDG PET/CT Imaging

Objective:1.The correlation between the SUVmax value and the positive rate of Ki-67 of different pathological types of NHL was compared and analyzed in combination with clinical parameters,so as to predict the Ki-67 index of a certain type of NHL more accurately through the non-invasive and easily obtained SUV value,so as to indirectly reflect the invasion degree of lymphoma lesions and the prognosis of patients.2.The prognosis of DLBCL patients was analyzed by multivariate analysis based on baseline PET/CT tumor burden indicators,such as MTV,TLG and SUVmax,combined with patients’ clinical parameters and laboratory indicators,in order to find baseline parameters that could better reflect the prognosis of newly diagnosed DLBCL patients.Methods:A total of 185 newly diagnosed NHL patients who underwent PET/CT examination in Shanxi Cancer Hospital from January 2015 to July 2020 were collected,including 94 patients with DLBCL.NHL patients were divided into aggressive B cell NHL,inert B cell NHL and T cell NHL according to cell origin and invasion degree.Chi-square test was used to analyze the correlation between SUVmax value and the positive rate of Ki-67 and different clinical parameters in NHL patients.The correlation between SUVmax value and the positive rate of Ki-67 in different pathological subtypes was analyzed by correlation test.Univariate and multivariate analyses were performed for prognosis of DLBCL patients with multiple clinical parameters,laboratory indicators,and baseline PET/CT metabolic parameters.K-M survival curves were used for survival analysis.Results:In 185 newly diagnosed NHL patients,the SUVmax and Ki-67 of invasive B cell NHL were significantly higher than those of inert B cell NHL and T cell NHL(P<0.05),and the SUVmax and Ki-67 of inert B cell NHL were significantly lower than those of invasive B cell NHL and T cell NHL(P<0.05).SUVmax and Ki-67 were closely correlated with the maximum lesion diameter,extrinsic invasion,invasion degree,LDH and IPI score(P<0.05).SUVmax is closely related to Ki-67(r=0.615).The ROC curve analysis showed that the invasiveness could be reflected by the SUVmax and Ki-67 in NHL.In the prognosis analysis of 94 patients with DLBCL,the age,maximum lesion diameter,B symptoms or not,Annarbor stage,LDH,NCCN-IPI score,Ecog,Bcl-2,MYC,MTV and TLG could be better predicted the progression or recurrence of DLBCL patients before treatment by univariate analysis(P<0.05).The Ecog,MTV and TLG were independent risk factors for PFS by Multivariate analysis(P<0.05).Conclusion:1.Using pathological Ki-67 index as the gold standard,baseline SUVmax can reflect the invasion degree of NHL lesions;The combination of the pathological Ki-67 index and baseline SUVmax can identify NHL lesions with different levels of invasion and NHL with different cell origins.2.Combined with clinical parameters,laboratory indicators and baseline PET metabolic parameters,MTV and TLG are independent predictors for evaluating the prognosis of newly diagnosed DLBCL patients,as well as imaging indicators for more timely,earlier,more stable and more accurate prognosis evaluation of DLBCL patients.