PET/CT、骨髓活检及骨髓涂片评估弥漫大B细胞淋巴瘤骨髓侵犯的应用及预后价值

OBJECTIVE: This study aimed to determine the value of bone marrow biopsy（BMB）, bone marrow aspiration（BMA）, and positron emission tomography combined with computed tomography（PET/CT）in bone marrow（BM）involvement and prognosis evaluation in diffuse large B-cell lymphoma（DLBCL）. METHODS: The clinical data of patients with DLBCL who underwent PET/CT, BMB, and BMA of the iliac crest were retrospectively analyzed in Peking Union Medical College Hospital from January 2015 to November 2017. The BM involvement on PET/CT was defined as the ratio of maximal standardized uptake values of iliac crest BM to liver parenchyma intensity ≥1. RESULTS: A total of 76 patients without liver involvement were enrolled, there were 32 males, and the median age was 53（17-79）. Moreover, 16 patients（21.1％）had BM involvement on PET/CT, 12（15.8％）had positive BMB, and 13（17.1％）had positive BMA. Excellent correlation between BMA and BMB（κ＝0.943）was found, including good correlation between PET/CT and BMB/BMA（κ＝0.763 and 0.776, respectively）. After a median follow-up of 52（0-82）months, BM involvement by BMB（P＝0.037）and BMA（P＝0.007）were poor prognostic factors for overall survival, positive PET/CT had no significant effect on prognosis（P>0.05）. CONCLUSION: PET/CT, BMB, and BMA are effective methods to detect BM involvement with great concordance. However, iliac crest BMB and BMA showed superior performance in prognosis evaluation.