文章：

利用R-ISS分期与18F-FDG PET/CT显像构建初诊多发性骨髓瘤新型风险分层体系

Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and 18F-FDG PET/CT

原文发布日期：2021-12-01

DOI: 10.1038/s41408-021-00577-2

类型: Article

开放获取: 是

英文摘要：

In multiple myeloma (MM), a high number of focal lesions (FL) detected using positron emission tomography/computed tomography (PET/CT) was found to be associated with adverse prognosis. To design a new risk stratification system that combines the Revised International Staging System (R-ISS) with FL, we analyzed the data of 380 patients with newly diagnosed MM (NDMM) who underwent 18F-fluorodeoxyglucose (18F-FDG) PET/CT upon diagnosis. The K-adaptive partitioning algorithm was adopted to define subgroups with homogeneous survival. The combined R-ISS with PET/CT classified NDMM patients into four groups: R-ISS/PET stage I (n = 31; R-ISS I with FL ≤ 3), stage II (n = 156; R-ISS I with FL > 3 and R-ISS II with FL ≤ 3), stage III (n = 162; R-ISS II with FL > 3 and R-ISS III with FL ≤ 3), and stage IV (n = 31; R-ISS III with FL > 3). The 2-year overall survival rates for stages I, II, III, and IV were 96.7%, 89.8%, 74.7%, and 50.3%. The 2-year progression-free survival rates were 84.1%, 64.7%, 40.8%, and 17.1%, respectively. The new R-ISS/PET was successfully validated in an external cohort. This new system had a remarkable prognostic power for estimating the survival outcomes of patients with NDMM. This system helps discriminate patients with a good prognosis from those with a poor prognosis more precisely.
 

摘要翻译： 

在多发性骨髓瘤（MM）中，通过正电子发射断层扫描/计算机断层扫描（PET/CT）检测到的大量局灶性病变（FL）被发现与不良预后相关。为设计一种将修订版国际分期系统（R-ISS）与FL相结合的新风险分层系统，我们分析了380例新诊断多发性骨髓瘤（NDMM）患者的数据，这些患者在诊断时接受了¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）PET/CT检查。采用K自适应分区算法来定义具有相似生存特征的亚组。结合R-ISS与PET/CT的新系统将NDMM患者分为四组：R-ISS/PET I期（n=31；R-ISS I期且FL≤3）、II期（n=156；R-ISS I期且FL>3以及R-ISS II期且FL≤3）、III期（n=162；R-ISS II期且FL>3以及R-ISS III期且FL≤3）和IV期（n=31；R-ISS III期且FL>3）。I、II、III和IV期的2年总生存率分别为96.7%、89.8%、74.7%和50.3%；2年无进展生存率分别为84.1%、64.7%、40.8%和17.1%。这一新的R-ISS/PET系统在外部队列中成功得到验证，对NDMM患者的生存结局具有显著的预后评估能力，有助于更精确地区分预后良好与不良的患者。

原文链接：

Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and 18F-FDG PET/CT