| Objective:To compare the efficacy and prognostic evaluation of response evaluation criteria in lymphoma（RECIL）and Lugano standard in patients with Hodgkin′s lymphoma（HL）and non-Hodgkin′s lymphoma（NHL）with high affinity for 18F-FDG at the middle stage of chemotherapy.Method:From January 2015 to August 2021,240 patients[149 males and 91 females,age50.0（32.0,62.0）years]with pathologically confirmed lymphoma[96 HL,30 follicular lymphoma（FL）,114 diffuse large B-cell lymphoma（DLBCL）]in Shanxi Provincial Cancer Hospital were retrospectively analyzed.18F-FDG PET/CT examinations were performed before and at the middle stage of treatment respectively,and the differences of PET/CT imaging results among patients with different types of lymphoma were analyzed（χ2 test or Kruskal-Wallis rank sum test）.Efficacy evaluation was conducted in the middle stage of chemotherapy,and the results were divided into complete remission（CR）,partial remission（PR）,stable disease（SD）,progressive disease（PD）according to Lugano standard,which was divided into CR,PR,mild remission（Mi R）,SD,PD according to RECIL standard.For the better comparison with Lugano standard,Mi R was included in PR group（recorded as RECIL-1）and SD group（recorded as RECIL-2）in this study.All patients were followed up,and the progression free survival（PFS）was analyzed.Kappa test,χ2 test or Fisher exact probability method were used to analyze the data,and ROC curve was used to compare the prediction efficiency of different standards.Results:Among 240 patients with different types of lymphoma,there were statistically significant differences in baseline SUVmax（H=54.96,P<0.001）and the sum of longest diameters（H=15.85,P<0.001）.Patients were followed up for 12-89 months,and 26patients（10.8%）were evaluated as Mi R according to the RECIL standard.The consistency（Kappa）was 0.84 between results of RECIL-1 and Lugano standard,which was 0.74 between RECIL-2 and Lugano standard（both P<0.001）.According to Lugano standard,the PFS rates of patients evaluated as CR,PR,SD and PD were91.4%（148/162）,57.1%（36/63）,1/3 and 3/12 respectively,which was 91.3%（136/149）,62.8%（49/78）,1/2 and 2/11 for RECIL-1,and 91.3%（136/149）,57.7%（30/52）,71.4%（20/28）and 2/11 for RECIL-2 respectively（χ2 values:46.64-52.44,all P<0.001）.The AUC of PFS of Lugano standard for predicting PFS had a trend to be higher than that of RECIL-1 and RECIL-2（0.774,0.758 and 0.746,z values:1.28,1.61,P values:0.200,0.107）.Conclusion:The efficacy and prognosis of HL and NHL patients with high affinity of 18F-FDG were evaluated by the RECIL standard and Lugano standard in the middle stage of chemotherapy.Objective:To explore the prognostic evaluation of 18F-FDG PET/CT RECIL standard for patients with non-Hodgkin’s lymphoma（NHL）after autologous hematopoietic stem cell transplantation（ASCT）and the comparative study with Lugano standard.Method:A retrospective analysis of 86 patients with pathologically confirmed NHL [63males,23 females,34.0（22.0,47.3）years old] was performed between October2010 and November 2021,including 34 cases of diffuse large B cell lymphoma（DLBCL）,21 cases of natural killer/T-cell lymphoma（NKTCL）and 31 cases of other types of lymphoma.18F-FDG PET/CT imaging was performed before and after autotransplantation.According to the RECIL standard,the efficacy was evaluated after ASCT [divided into effective group: complete remission（CR）,partial remission（PR）,mild remission（Mi R）;ineffective group: disease stability（SD）,disease progression（PD）],and the differences of clinical indicators and PET/CT parameters between different groups were compared（Pearson chi-square test,Fisher exact probability method and Mann-Whitney U test）;Cox proportional risk regression model was used to conduct univariate and multivariate analysis to explore the relevant factors affecting the prognosis of NHL patients after ASCT.According to Lugano’s standard,the efficacy was evaluated and divided into complete remission group（CR）,partial remission group（PR）and ineffective group（SD+PD）.According to RECIL standard,the efficacy was divided into complete remission group（CR）,partial remission group（PR+Mi R）and ineffective group（SD+PD）.The total survival（OS）of 3 years was analyzed.Kappa test and Kaplan-Meier survival analysis were used to analyze the data,and ROC curve was used to compare the predictive efficacy of RECIL standard and Lugano standard.Results:A median follow-up of 36（6-118）months showed that the 3-year OS rate of 86 patients was 12.8%（11/86）.There were statistically significant differences between the effective group and the ineffective group in terms of SUVmax after transplantation,the number of chemotherapy programs before transplantation and the timing of transplantation（all P<0.05）;Cox univariate analysis showed that the RECIL standard,post-transplant SUVmaxx,number of pre-transplant chemotherapy programs and transplant timing were the influencing factors of 3-year OS（all P<0.05）.Cox multivariate analysis showed that the RECIL standard was the independent risk factor of 3-year OS（P<0.05）;The RECIL standard and Lugano standard have high consistency in the efficacy evaluation after ASCT（Kappa=0.77,P<0.001）.Kaplan-Meier survival analysis showed that there was significant difference in 3-year OS rate between RECIL standard and Lugano standard among complete remission group,partial remission group and ineffective group（all P<0.001）.RECIL standard predicts that the AUC of OS in 3 years is slightly higher than that of Lugnao standard（0.884,0.865;P>0.05）.Conclusion:The RECIL standard after ASCT can accurately evaluate the prognosis of NHL patients.The RECIL standard and Lugano standard have the same effect on the efficacy and prognosis of NHL patients after ASCT. |
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