Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography metabolic parameters combined with serum apolipoprotein A1 in patients with diffuse large B-cell lymphoma: a clinical study.

Background: Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive tumor. This study aims to assess the value of metabolic parameters from 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) combined with serum apolipoprotein A1 (ApoA1) in predicting the prognosis of patients with DLBCL. Methods: A total of 138 newly diagnosed DLBCL patients were consecutively enrolled at our institution from January 1, 2015, to December 31, 2019. All patients underwent 18F-FDG PET/CT using a Siemens Biograph mCT PET/CT scans upon admission to determine baseline metabolic parameters and were tested for ApoA1 levels. The relationship between progression-free survival (PFS) and the maximum standardized uptake value (SUVmax), total metabolic tumor volume (tMTV), and serum ApoA1 was explored. Results: The ApoA1 levels were 0.94 [interquartile range (IQR), 0.89, 1.05], ranging from 0.58 to 1.26; tMTV levels were 343 (IQR, 306, 360) mL, ranging from 255 to 416; and SUVmax levels were 18.6 (15.6, 21.8), ranging from 8.7 to 29.3. Analysis based on median ApoA1, tMTV, and SUVmax levels showed that compared with the high ApoA1, low tMTV, and low SUVmax group, the PFS was significantly reduced in the low ApoA1, high tMTV, and high SUVmax group. After adjusting for National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) and pathological diagnosis, ApoA1, SUVmax, and tMTV remained independent factors affecting PFS. Conclusions: In DLBCL patients, high levels of metabolic parameters from 18F-FDG PET/CT (SUVmax and MTV) and low levels of serum ApoA1 indicate a poorer survival outcome, suggesting that these parameters could serve as potential biomarkers for treatment response and survival results.