Abstract
Objective To assess the value of 18F-fluorodeoxyglucose (FDG) PET/CT in the staging, interim therapeutic and prognostic evaluation of mucosa-associated lymphoid tissue (MALT) lymphoma. Methods Thirty-six MALT lymphoma patients (20 males, 16 females; average age: 61.7 years) confirmed by pathology from January 2008 to January 2018 were retrospectively analyzed.18F-FDG PET/CT were performed before chemotherapy and radiotherapy for staging. The detective sensitivity was evaluated. The staging results of gastric MALT lymphoma and extragastric MALT lymphoma by PET/CT were compared with Fisher exact probability method. PET/CT was performed in 17 of 36 patients after 4 courses of chemotherapy, and 17 patients were divided into positive group (≥4) and negative group (<4) according to scores of Deauville 5-point scale. The progression-free survival (PFS) was evaluated using Kaplan-Meier survival analysis. Results FDG-positive lesions were found in 31 of 36 patients with the sensitivity of 86.1%(31/36). The results of PET/CT were negative in stageⅠpatients. In stageⅡ-Ⅳ patients, the results of 18F-FDG PET/CT combined with bone marrow biopsy were in accordance with the results of clinical staging. The accuracy of PET/CT in staging of gastric MALT lymphoma patients was 9/17, which was significantly lower than that of extragastric MALT lymphoma patients (17/19; P=0.025). The PFS of negative group evaluated by interim PET/CT was longer than that of positive group (χ2=4.16, P<0.05). The 2-year PFS rates of the 2 groups were (85.7±13.2)% and (27.8 ±21.3)%, respectively. The PFS of patients with low expression of Ki-67 was significantly longer than that of patients with high Ki-67 expression(χ2=4.22, P<0.05). Conclusions In stageⅡ-Ⅳ MALT patients, 18F-FDG PET/CT combined with bone marrow biopsy can improve the staging accuracy. The staging accuracy of PET/CT in extragastric MALT lymphoma is significantly higher than that of gastric MALT lymphoma. PET/CT and Ki-67 can provide effective information on the prognostic evaluation for patients with MALT lymphoma. Key words: Lymphoma, B-cell, marginal zone; Neoplasm staging; Prognosis; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose
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