ABVD化疗方案对霍奇金淋巴瘤患者睾丸18F-FDG代谢的影响
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南京医科大学第一附属医院

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The impact of ABVD chemotherapy regime on testicular 18F-FDG uptake in patients with Hodgkin’s lymphoma
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the First Affiliated Jiangsu Province Hospital Affiliated to Nanjing Madical University

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    摘要:

    目的:本文旨在探讨霍奇金淋巴瘤(Hodgkin’s lymphoma,HL)患者在ABVD(阿霉素、博来霉素、长春碱、氮烯咪胺,简称ABVD)方案化疗过程中睾丸18F-FDG代谢的变化情况。方法:回顾性分析34例利用18F-FDG PET/CT进行疗效评估的HL患者的资料。所有患者均使用ABVD化疗方案进行了六个疗程的化疗,且在基线期及每两次疗程化疗后总共进行了四次18F-FDG PET/CT检查评估。收集患者四次行18F-FDG PET/CT检查时的血糖、体重、注射剂量、注射时间;测量患者每次18F-FDG PET/CT检查的睾丸及纵膈血池的最大标准摄取值(SUVmax)。通过单因素重复测量分析(单因素方差分析)方法分析HL患者在四次18F-FDG PET/CT检查后睾丸18F-FDG代谢的变化情况。结果:34例HL患者四次18F-FDG PET/CT检查时的血糖、注射剂量、注射时间、纵膈血池SUVmax及睾丸SUVmax/纵膈血池SUVmax值的差异无统计学意义(P=0.088,0.344,0.648,0.260,0.085);四次检查过程中睾丸SUVmax和体重的差异有统计学意义(P=0.017,0.001)。HL患者第二次PET/CT检查时的睾丸SUVmax较第一次减低了0.998(95%可信区间CI:0.015-1.980),P=0.045;但后两次睾丸SUVmax与第一次无明显变化(P=0.302,0.137),并且后三次PET/CT检查时睾丸SUVmax未见明显变化(P>0.05)。患者在第一次PET/CT检查时(基线期)的睾丸SUVmax与纵膈血池SUVmax之间的存在正相关(r=0.51,P=0.002),而睾丸SUVmax与年龄之间无相关性(P=0.646)。患者在后三次PET/CT检查时的体重均较第一次增高(P=0.009,0.004,0.016),但未发现后三次检查患者的体重有差异(P>0.05)。结论:在接受ABVD方案化疗的HL患者中,睾丸的18F-FDG代谢程度在化疗过程中存在一过性减低,但后期可恢复;因此ABVD化疗方案可能对HL患者性腺功能的影响不大。 [关键词] 霍奇金淋巴瘤;化疗;PET/CT;睾丸18F-FDG代谢

    Abstract:

    Objective: To investigate the impact of ABVD(adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy regime on the testicular 18F-fluorodeoxyglucose (FDG) uptake in patients with Hodgkin’s lymphoma (HL). Methods: Thirty-four patients at diagnosis monitored with 18F-FDG on positron emission tomography (PET) / computed tomography (CT) to assess treatment response for HL were selected for this retrospective analysis. The patients received ABVD chemotherapy regimen for six courses. The four 18F-FDG PET/CT examinations were performed at baseline and after every two courses of chemotherapy. Blood glucose, body weight, injection dose and injection time were collected, and the maximum standardized uptake value (SUVmax) of testis and mediastinal blood pool were measured. The changes of testicular 18F-FDG uptake in patients with HL after four 18F-FDG PET/CT examinations were analyzed by single-factor repeated measures one-way analysis of variance (ANOVA). Results: There were no significant changes in blood glucose, injection dose, injection time, mediastinal blood pool SUVmax and testicular SUVmax/ mediastinal blood pool SUVmax at four PET/CT examinations for 34 cases with HL(all P>0.05). There were statistical significance in testis SUVmax and weight (P=0.017,0.001). Compared with the testicular SUVmax at the first PET/CT examination, the testicular SUVmax at the second time decreased by 0.998 (95%CI: 0.015 -1.980), P=0.045. There were no significant differences in testicular SUVmax between the last two time points and the first time or over the course of chemotherapy(P>0.05). The testis SUVmax were found to be positively correlated with mediastinal blood pool SUVmax at the first PET/CT examination (baseline) (r=0.51, P=0.002), but not with age (P=0.646). The weight at last three PET/CT was higher than at the first time (P = 0.009, 0.004, 0.016), but no changes were found during at last three PET/CT examinations (P > 0.05). Conclusion: For patients undergoing ABVD chemotherapy regime for Hodgkin’s lymphoma, the testicular 18F-FDG uptake decreased temporarily over the course of chemotherapy, but recovered in the later. Therefore, ABVD chemotherapy regime may have little effect on gonadal function of patients with Hodgkin’s lymphoma. [Keywords] Hodgkin’s lymphoma, chemotherapy, PET/CT, testicular 18F-FDG uptake

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  • 收稿日期:2020-11-09
  • 最后修改日期:2021-07-19
  • 录用日期:2021-10-29
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