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目的:用MRI和18F-FDG PET/CT准确揭示眼附属器MALT淋巴瘤(OAML)患者的病灶,探讨病灶分布规律及临床病理特点。方法:23例初诊OAML患者确诊前、后行MRI及18 F-FDG PET/CT检查,分析病灶在眼附属器的分布及向全身播散的特点,并总结Ki67阳性率、ALB、LDH、β2-MG、SUVmax、B症状的特点。结果:每位患者手术前MRI检查至少发现一处病灶,单眼累及者82.6%,双眼累及17.4%;病灶累及眼眶、眼睑、泪腺、结膜的比例分别为60.9%(14/23)、56.5%(13/23)、26.1%(6/23)和13.0%(3/23)。确诊后行全身PET/CT检查,11例(47.8%)患者眼部病灶完全切除且全身无异常代谢活性病灶,12例患者眼部仍有异常代谢活性病灶,SUVmax 5.8±3.0,其中4例患者存在眼部外病灶,主要累及颈部、纵膈、盆腔淋巴结。PET/CT阴性和阳性组患者之间眼部病灶分布无显著性差异,淋巴瘤细胞Ki67阳性率有显著差异。所有患者均无B症状、无贫血、无低白蛋白血症;β2-MG升高者2例,LDH升高者1例,均为PET/CT发现眼外病灶患者。PET/CT阴性患者均观察随诊,阳性患者选择了联合化疗、局部放疗或观察随诊。结论:大多数OAML患者病灶在局部,MRI和PET/CT能较好地显示眼部及全身病灶,对制定治疗方案有重要价值。有播散病灶者,β2-MG及LDH有增高趋势。
OBJECTIVE: To accurately reveal the lesions of patients with ocular adnexal MALT lymphoma (OAML) by using MRI and 18F-FDG PET / CT and investigate the distribution and clinicopathological features of the lesions. Methods: Twenty-three newly diagnosed OAML patients were examined with MRI and 18F-FDG PET / CT before and after diagnosis. The distribution of the lesions in the appendix and the dissemination to the whole body were analyzed. The positive rates of Ki67, ALB, LDH, β2 -MG, SUVmax, B symptoms of the characteristics. Results: At least one lesion was found in each patient before operation, with 82.6% in unilateral eyes and 17.4% in both eyes. The proportions of lesions involving eyes, eyelids, lacrimal glands and conjunctiva were 60.9% (14/23) and 56.5% 13/23), 26.1% (6/23) and 13.0% (3/23). After the diagnosis, the whole body PET / CT examination was performed. In 11 patients (47.8%), the ocular lesions were completely resected and the whole body had no abnormal metabolic activity. In 12 patients, there were still abnormal metabolic activity in the eyes, SUVmax was 5.8 ± 3.0, of which 4 patients There are extraocular lesions, mainly involving the neck, mediastinum, pelvic lymph nodes. There was no significant difference in the distribution of ocular lesions between PET / CT negative and positive groups, and the Ki67 positive rate of lymphoma cells was significantly different. All patients had no symptoms of B, no anemia, no hypoalbuminemia, 2 patients with elevated β2-MG and 1 patient with elevated LDH, all of whom had extra-ocular lesions by PET / CT. PET / CT negative patients were followed up, the positive patients choose combination chemotherapy, local radiotherapy or follow-up observation. Conclusion: Most OAML patients with focal, local, MRI and PET / CT can better show the ocular and systemic lesions, the development of treatment programs of great value. Have disseminated lesions, β2-MG and LDH increased trend.