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目的:探讨n 18F-FDG PET/CT显像及相关因素在原发性胃肠道淋巴瘤(PGIL)患者的中期疗效与预后评估中的价值。n 方法:回顾性分析2008年1月至2018年1月间在上海交通大学医学院附属第一人民医院经病理证实为B细胞PGIL，且在化疗、放疗前及中期(3~4程)化疗后行n 18F-FDG PET/CT显像的患者41例(男24例、女17例，年龄26~84岁)，包括黏膜相关淋巴组织(MALT)淋巴瘤17例、弥漫性大B细胞淋巴瘤(DLBCL) 24例。采用Mann-Whitney n U检验比较MALT淋巴瘤和DLBCL患者治疗前代谢参数[SUVn max、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)]的差异；采用ROC曲线分析不同参数对无进展生存(PFS)的预测能力；采用Cox回归分析探讨PFS的影响因素。n 结果:41例患者的中位随访时间为25(6~84)个月，3年PFS率为55.9%，总生存(OS)率为80.2%。治疗前，DLBCL患者的SUVn max(23.2±11.9)、MTV[260.7(66.2，740.7) cmn 3]和TLG[1 902.9(592.2，8 418.1) g]均明显高于MALT淋巴瘤患者[7.9(6.2，9.8)、45.9(28.4，104.2) cmn 3、121.1(72.8，295.6) g；n z值：-4.02、-3.10、-3.92,均n P<0.05]。DLBCL的治疗前后参数的变化值ΔSUVn max(AUC＝0.80，n P＝0.012)、MALT淋巴瘤和DLBCL治疗前后参数变化率ΔSUVn max%(AUC＝0.89，n P＝0.007；AUC＝0.80，n P＝0.012)、ΔMTV%(AUC＝0.91，n P＝0.005；AUC＝0.77，n P＝0.026)和ΔTLG%(AUC＝0.87，n P＝0.011；AUC＝0.77，n P＝0.026)可预测PFS。Cox多因素分析示，MALT淋巴瘤的ΔSUVn max%是PFS的独立预测因素[风险比(n HR)＝17.192，95% n CI: 2.035~145.245，n P＝0.009]，而ΔMTV%与ΔTLG%为DLBCL患者PFS的独立预测因素(均为n HR＝7.556，95% n CI: 1.968~29.016，n P＝0.003)。n 结论:MALT淋巴瘤和DLBCL治疗前代谢参数有明显差异。治疗中期PET/CT能在MALT淋巴瘤和DLBCL的预后预测中提供有价值信息。“,”Objective:To assess the value of n 18F-FDG PET/CT imaging and relevant factors in the interim therapeutic and prognostic evaluation of primary gastrointestinal lymphoma (PGIL) patients.n Methods:From January 2008 to January 2018, 41 patients with B-cell PGIL (24 males, 17 females; age: 26-84 years) confirmed by pathology in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively included. n 18F-FDG PET/CT was performed before chemotherapy and radiotherapy and after 3-4 courses of chemotherapy. There were 17 cases of mucosa-associated lymphoid tissue (MALT) lymphoma and 24 cases of diffuse large B-cell lymphoma (DLBCL). Mann-Whitney n U test was used to compare the differences of metabolic parameters (SUVn max, metabolic tumor volume (MTV), total lesion glycolysis (TLG)) before treatment between MALT lymphoma and DLBCL patients. ROC curve analysis was used to analyze the predictive abilities of different parameters for progression-free survival (PFS), and Cox regression analysis was used to analyze the influencing factors for PFS.n Results:The median follow-up time of 41 patients was 25 (6-84) months, with the 3-year PFS rate of 55.9% and the overall survival (OS) rate of 80.2%. The baseline SUVn max (23.2±11.9), MTV (260.7(66.2, 740.7) cmn 3) and TLG (1 902.9(592.2, 8 418.1) g) in DLBCL were significantly higher than those in MALT lymphoma (7.9(6.2, 9.8), 45.9(28.4, 104.2) cmn 3, 121.1(72.8, 295.6) g; n z values: -4.02, -3.10, -3.92, all n P<0.05). ΔSUVn max in DLBCL patients (AUC=0.80, n P=0.012), ΔSUV n max% (AUC=0.89, n P=0.007; AUC=0.80, n P=0.012), ΔMTV%(AUC=0.91, n P=0.005; AUC=0.77, n P=0.026) and ΔTLG% (AUC=0.87, n P=0.011; AUC=0.77, n P=0.026) in MALT lymphoma and DLBCL patients before and after treatment were predictive factors of PFS. Multivariate analysis showed that ΔSUV n max% was an independent factor for PFS of MALT lymphoma (hazard ratio (n HR)=17.192, 95% n CI: 2.035-145.245, n P=0.009), while ΔMTV% and ΔTLG% were factors for PFS of DLBCL (both n HR=7.556, 95% n CI: 1.968-29.016, n P=0.003).n Conclusions:There are significant differences in metabolic parameters between MALT lymphoma and DLBCL before treatment. Interim PET/CT is effective for the prediction of prognosis of MALT lymphoma and DLBCL.