■朗格汉斯细胞组织细胞增生症(LCH)是一种罕见的骨髓前体细胞炎性肿瘤,这很痛苦,maims,甚至杀死病人。尽管临床结果在过去几十年中稳步改善,LCH的进展/复发率仍然很高。这项研究的目的是评估LCH儿童基线18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDGPET/CT)的治疗前代谢参数的预后价值。
■这项横断面研究回顾性并连续包括37名儿童(24名男性和13名女性;中位年龄,5.1年;范围,2.4-7.8年),从2020年9月至2022年9月在核医学部进行治疗前18F-FDGPET/CT,北京友谊医院,首都医科大学,北京,中国。这些病人随后全部入院,经活检确诊为LCH,在血液学中心,北京儿童医院,首都医科大学,北京,中国。分析了18F-FDGPET/CT的5个代谢参数,包括最大的标准化摄取,肿瘤与正常肝脏标准摄取值之比,肿瘤与正常骨髓标准摄取值比率,代谢性肿瘤体积总和(sMTV),和所有病变的总病变糖酵解(sTLG)的总和。患者随访至少1年或直至疾病进展/复发。对无进展生存期进行单变量和多变量分析。
■随访期间,11例(29.7%)患者出现疾病进展/复发。单因素分析显示,危险器官受累,第5周或第11周的治疗反应,预处理sMTV,和sTLG与无进展生存期显著相关(P分别为0.024,0.018,0.006,0.006和0.042).多因素COX分析显示,在第11周无反应,治疗前sMTV>32.55g/cm3和sTLG>98.86g(P=0.002,0.020,0.026)是无进展生存期的危险因素.
■18F-FDGPET/CT的基线代谢参数可能是预测LCH患儿预后的成像生物标志物。
UNASSIGNED: Langerhans cell histiocytosis (LCH) is a rare myeloid precursor cell inflammatory neoplasia, which agonizes, maims, and even kills patients. Although clinical outcomes have steadily improved over the past decades, the progression/relapse rate of LCH remains high. The purpose of this study was to evaluate the prognostic value of the pre-treatment metabolism parameters of baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F‑FDG PET/CT) in children with LCH.
UNASSIGNED: This cross-sectional study retrospectively and consecutively included 37 children (24 males and 13 females; median age, 5.1 years; range, 2.4-7.8 years) with pre-treatment 18F-FDG PET/CT from September 2020 to September 2022 in Nuclear Medicine Department, Beijing friendship hospital, Capital Medical University, Beijing, China. These patients were then all admitted to the hospital and diagnosed with LCH by biopsy, in Hematology Center, Beijing Children\'s Hospital, Capital Medical University, Beijing, China. Five metabolism parameters of 18F-FDG PET/CT were analyzed, including maximum standardized uptake, tumor-to-normal liver standard uptake value ratio, tumor-to-normal bone marrow standard uptake value ratio, sum of metabolic tumor volume (sMTV), and sum of total lesion glycolysis (sTLG) of all lesions. Patients were followed up for at least 1 year or until disease progression/relapse. Univariate and multivariate analyses of progression-free survival was performed.
UNASSIGNED: During follow-up, 11 (29.7%) patients had disease progression/relapse. Univariate analysis revealed that the risk organ involvement, the treatment response at the 5th or 11th week, pre-treatment sMTV, and sTLG were significantly associated with progression-free survival (P=0.024, 0.018, 0.006, 0.006, and 0.042, respectively). Multivariate COX analysis revealed that non-response at the 11th week, pre-treatment sMTV >32.55 g/cm3, and sTLG >98.86 g (P=0.002, 0.020, 0.026, respectively) were risk factors for progression-free survival.
UNASSIGNED: The baseline metabolism parameters of 18F-FDG PET/CT could be promising imaging biomarkers for predicting prognosis in children with LCH.