Correlation Analysis Between Maximum Standard PETCT Intake And Clinicopathological Parameters Before Treatment Of Non-hodgkin’s Lymphoma

Background and purpose:Lymphoma is the most common malignancy of the blood system,and non-Hodgkin lymphoma is the most common malignancy.Non-hodgkin lymphoma includes both aggressive and intolerant types.Different types of NHL have different biological behaviors,so it is important to identify the type of NHL at an early stage for definite diagnosis and the selection of clinical individualized treatment plan.This study was aimed to investigate the correlation between 18F-FDG PET-CT SUVmax and various clinical pathological parameters before treatment of non-Hodgkin’s lymphoma,and the diagnostic value of SUVmax in invasive NHL.SPSS25.0 software was used to analyze the results.Method:A total of 119 patients with non-Hodgkin lymphoma admitted to the Department of Hematology,Zhongshan Hospital Affiliated to Dalian University from January 2017 to December 2022 were selected.The correlation between 18F-FDG PET-CT SUVmax and various clinicopathological parameters,such as sex,age,hematological indicators,pathological type,stage,grouping,IPI score,lesion size,Ki-67,etc.,was retrospectively analyzed in 119 patients before treatment.ROC curve was drawn to evaluate the diagnostic value of SUVmax and LDH in the invasion of NHL.The correlation between the expression of BCL-2,BCL-6 and CD5 in DLBCL and age and sex was analyzed.SPSS 25.0 software was used to analyze the results.Result:1.General condition:Among the 119 patients,46 were males（38.7%）and 73 were females（61.3%）.The ratio of males to females was 1.59:1,and females were more than males.The patients ranged in age from 25 to 87 years old,median age of 62 years old.55 patients（46.2%）were younger than 60 years old and 64 patients（53.8%）were older than 60 years old.Among 119 patients with NHL,73 cases（61.3%）of diffuse large B-cell lymphoma,21 cases（17.6%）of follicular lymphoma,5 cases（4.2%）of marginal zone lymphoma,5 cases（4.2%）of mantle cell lymphoma,4 cases（3.4%）of muco-associated lymphoid tissue exodal marginal zone lymphoma,3 cases（2.5%）of vascular immunoblastic T-cell lymphoma.There were 2 cases of follicular lymphoma（grade 3）（1.7%）,2 cases of peripheral T-cell lymphoma（non-specific type）（1.7%）,1case of NK/T-cell lymphoma,T lymphoblastic lymphoma,anaplastic large cell lymphoma and Burkitt lymphoma（0.8%）each.2.Of 119 newly diagnosed NHL patients,age group≤60 years old（n=55）and age group>60 years old（n=64）,SUVmax of patients aged>60 years was higher than that of patients aged≤60 years（20.87±12.39vs.16.37±10.45,P=0.036）;The critical value of LDH was 250U/L and divided into increased LDH group（n=62）and normal LDH group（n=57）.The SUVmax in increased LDH group was higher than that in normal LDH group（24.44±12.36vs.12.65±6.99,P<0.001）;β2-MG was divided intoβ2-MG increase group（n=55）andβ2-MG normal group（n=64）with a critical value of 2.7mg/L.The SUVmax ofβ2-MG increase group was higher than that ofβ2-MG normal group（25.80±12.04vs.12.76±7.27,P=<0.001）;Ki-67 was divided into≥80%group and<80%group with 80%as the critical value.The SUVmax of Ki-67≥80%group was higher than that of Ki-67<80%group（21.93±11.34vs.16.10±11.43,P=0.006）;Lesions with2cm as the critical value were divided into>2cm group and≤2cm group,the SUVmax in lesion>2cm group was higher than that in lesion≤2cm group（21.76±12.81vs.13.55±6.92,P<0.001）.3.Correlation between SUVmax and clinicopathologic parameters in NHL patients:SUVmax was correlated with age（r=0.209,P=0.023）,LDH（r=0.541,P<0.001）,β2-MG（r=0.203,P=0.027）,Ki-67（r=0.377,P<0.001）,lesion size（r=0.325,P<0.001）is positively correlated.4.SUVmax and LDH predicted the malignancy of NHL:When SUVmax was13.05g/ml,the maximum Yoden index（0.587）was obtained,and the sensitivity and specificity were 80.0%and 78.7%,respectively.The area under the ROC curve of SUVmax was 0.846 and the standard error was 0.041.95%confidence interval（0.765,0.928）;When LDH was used to predict the invasivity of NHL,the maximum Yoden index（0.496）was obtained when LDH was 253U/L,and the sensitivity and specificity for the diagnosis of invasive lymphoma were 49.6%,86.7%,area under the ROC curve was 0.759,standard error was 0.046,95%confidence interval（0.669,0.849）;The ROC curve of the combined detection of NHL malignity by SUVmax and LDH showed the maximum Yoden index（0.631）,the sensitivity and specificity of the diagnosis of invasive lymphoma were 63.1%and 80%,the area under the ROC curve of SUVmax and LDH was 0.831,and the standard error was 0.035.95%confidence interval（0.805,0.942）.5.Differences of expression of BCL-2,BCL-6 and CD5 in NHL with age and sex and malignant degree:According to Pearson chi-square test,among 119 NHL patients,CD5 expression in patients（n=45）was correlated with age（P=0.001）,and CD5expression was more likely in patients under 60 years of age.119 NHL patients,BCL-2expression in patients（n=78）was correlated with the degree of malignancy and is more common in patients with high invasiveness.There were no significant differences in the expression of BCL-2 and BCL-6 between age and sex groups.Conclusion:1.¹⁸F-FDG PET-CT SUVmax can evaluate the invasiveness of NHL and has good value when combined with LDH to predict the invasiveness of NHL.2.¹⁸F-FDG PET-CT SUVmax was correlated with a variety of clinicopathological parameters,and was positively correlated with age,LDH,β₂-MG,Ki-67,and lesion size.3.CD5 expression is more common in patients under 60 years of age,BCL-2expression is more common in patients with high invasiveness.