文章：

正电子发射断层扫描-计算机断层扫描在冒烟型多发性骨髓瘤诊断评估中的应用：识别需要治疗的患者

Positron emission tomography-computed tomography in the diagnostic evaluation of smoldering multiple myeloma: identification of patients needing therapy

原文发布日期：2015-10-23

DOI: 10.1038/bcj.2015.87

类型: Original Article

开放获取: 是

英文摘要：

We studied 188 patients with a suspected smoldering multiple myeloma (MM) who had undergone a positron emission tomography-computed tomography (PET-CT) scan as part of their clinical evaluation. PET-CT was positive (clinical radiologist interpretation of increased bone uptake and/or evidence of lytic bone destruction) in 74 patients and negative in 114 patients. Of these, 25 patients with a positive PET-CT and 97 patients with a negative PET-CT were observed without therapy and formed the study cohort (n=122). The probability of progression to MM within 2 years was 75% in patients with a positive PET-CT observed without therapy compared with 30% in patients with a negative PET-CT; median time to progression was 21 months versus 60 months, respectively, P=0.0008. Of 25 patients with a positive PET-CT, the probability of progression was 87% at 2 years in those with evidence of underlying osteolysis (n=16) and 61% in patients with abnormal PET-CT uptake but no evidence of osteolysis (n=9). Patients with positive PET-CT and evidence of underlying osteolysis have a high risk of progression to MM within 2 years when observed without therapy. These observations support recent changes to imaging requirements in the International Myeloma Working Group updated diagnostic criteria for MM.

摘要翻译： 

我们研究了188例疑似惰性多发性骨髓瘤（MM）患者，这些患者均在其临床评估过程中接受了正电子发射断层扫描-计算机断层扫描（PET-CT）检查。其中74例患者PET-CT结果呈阳性（临床放射科医生判读显示骨摄取增加和/或存在溶骨性破坏证据），114例患者结果为阴性。在此群体中，25例PET-CT阳性患者和97例阴性患者在未接受治疗的情况下接受观察，共同构成研究队列（n=122）。未治疗观察组中，PET-CT阳性患者2年内进展为MM的概率为75%，而阴性患者为30%；中位进展时间分别为21个月与60个月（P=0.0008）。在25例PET-CT阳性患者中，存在潜在溶骨性病变者（n=16）2年内疾病进展概率为87%，而PET-CT摄取异常但无溶骨证据者（n=9）进展概率为61。研究结果表明，PET-CT阳性且存在潜在溶骨性病变的患者在未接受治疗的情况下，2年内进展为MM的风险极高。这些发现为国际骨髓瘤工作组最新修订的MM诊断标准中影像学要求的更新提供了支持依据。

原文链接：

Positron emission tomography-computed tomography in the diagnostic evaluation of smoldering multiple myeloma: identification of patients needing therapy