背景评估弥漫性大B细胞淋巴瘤(DLBCL)的骨髓受累(BMI)对分期具有重要意义。预后,和治疗目的。用于鉴定骨髓受累的金标准方法是骨髓活检(BMB),但是它有一定的缺点。近年来,正电子发射断层扫描/计算机断层扫描(PET/CT)已成为诊断和分期淋巴瘤的高效方法。目的本研究的目的是评估PET/CT在识别拉合尔癌症护理医院DLBCL患者骨髓受累中的诊断准确性。使用BMB作为参考标准。方法本描述性横断面研究于2013年1月1日至2018年12月31日在ShaukatKhanum纪念肿瘤医院病理科和研究中心(SKMCH&RC)进行。从医院信息系统(HIS)中检索了146例符合纳入和排除标准的患者的回顾性数据。纳入标准包括18-80岁的患者,无论男女,并在组织活检中确诊为DLBCL。排除标准包括已经开始化疗或放疗治疗DLBCL或在PET/CT扫描之前使用粒细胞集落刺激因子(G-CSF)的患者。所有患者均行PET/CT和BMB,计算PET/CT的诊断准确性,以BMB为参考标准。结果病例平均年龄为52.73±16.27岁。男性95例(65.1%),女性51例(34.9%),男女比例很高。在本研究中,32.19%的病例骨髓受累于BMB,34.2%的病例在PET/CT上有骨髓受累。敏感性,特异性,阳性预测值(PPV),负预测值(NPV),PET/CT的总体诊断准确率为93.61%,93.93%,88%,96.88%,和93.84%,分别。结论PET/CT扫描具有良好的敏感性,特异性,正预测值,负预测值,和诊断的准确性。所以,建议选择这种非侵入性技术,因为也可以检测到髓外空间中疾病的存在,并且可以进行全身骨髓的评估。PET/CT扫描是检测DLBCL患者骨髓受累的有效成像方式,与骨髓活检相比,其相对优势可能得出结论,这是一种首选技术。
Background It is of great importance to assess bone marrow involvement (BMI) in diffuse large B cell lymphoma (DLBCL) for staging, prognostic, and therapeutic purposes. The gold standard method used for the identification of bone marrow involvement is bone marrow biopsy (BMB), but it has certain drawbacks. In recent years, positron emission tomography/computed tomography (PET/CT) has become a highly effective method in the diagnosis and staging of lymphoma. Objective The objective of this study is to estimate the diagnostic accuracy of PET/CT in identifying bone marrow involvement in DLBCL patients in a cancer care hospital in Lahore, using BMB as a reference standard. Methods This descriptive cross-sectional study was conducted at the Department of Pathology of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) from January 1, 2013, to December 31, 2018. A retrospective data of 146 patients fulfilling the inclusion and exclusion criteria was retrieved from the hospital information system (HIS). The inclusion criteria include patients aged 18-80 years, of either gender, and with a confirmed diagnosis of DLBCL on tissue biopsy. The exclusion criteria include patients who had started chemotherapy or radiotherapy for DLBCL or were using granulocyte colony-stimulating factor (G-CSF) prior to their PET/CT scan. All patients underwent PET/CT and BMB, and the diagnostic accuracy of PET/CT was calculated, with BMB taken as the reference standard. Results The mean age of cases was 52.73 ± 16.27 years. There were 95 (65.1%) male and 51 (34.9%) female cases, with a high male-to-female ratio. In the present study, 32.19% of cases had bone marrow involvement on BMB, and 34.2% of cases had bone marrow involvement on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy of PET/CT were found to be 93.61%, 93.93%, 88%, 96.88%, and 93.84%, respectively. Conclusion It is concluded that PET/CT scan has good sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. So, it is suggested to choose this non-invasive technique because the presence of a disease in extra-medullary space can also be detected and the evaluation of bone marrow in the whole body can be performed. PET/CT scan is an effective imaging modality in the detection of bone marrow involvement in DLBCL patients, and its relative advantages over bone marrow biopsy might conclude this to be a preferred technique.