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目的:研究治疗前n 18F-FDG PET/CT显像的代谢参数对老年经典型霍奇金淋巴瘤(cHL)的预后价值。n 方法:回顾性分析2011年4月至2020年4月间于南京医科大学第一附属医院经病理确诊的42例老年cHL患者(男29例、女13例，中位年龄69岁)治疗前的临床及PET/CT显像资料。以41%SUVn max为阈值获得病灶的肿瘤代谢体积(MTV)和病灶糖酵解总量(TLG)。利用ROC曲线分析获得SUVn max、MTV、TLG的预后最佳阈值。采用Kaplan-Meier法和log-rank检验进行单因素生存分析，采用Cox比例风险回归模型进行多因素分析。n 结果:42例老年cHL患者的SUVn max、MTV、TLG分别为16.49(12.24，23.59)、79.29(26.29，184.51) ml、729.02(206.03，2 073.98) g。ROC曲线分析示SUVn max、MTV、TLG的AUC分别为0.425、0.882、0.832；判断预后的最佳阈值分别为16.49、82.38 ml、556.26 g。单因素分析示年龄、B症状、乳酸脱氢酶(LDH)、Hb含量、Ann Arbor分期、德国霍奇金淋巴瘤研究组(GHSG)评分、MTV、TLG是患者无进展生存(PFS)率的影响因素(n χ2值：4.50~12.60，均n P<0.05)；年龄、B症状、LDH、Ann Arbor分期、GHSG评分、MTV、TLG是患者总生存(OS)率的影响因素(n χ2值：5.20~11.17，均n P<0.05)。多因素分析示MTV、TLG是影响患者PFS率的独立危险因素[相对危险度(n RR): 5.370(95% n CI: 1.697~16.277)、4.854(95% n CI: 1.228~23.352)，均n P<0.05]；GHSG评分、MTV、TLG是影响患者OS率的独立危险因素[n RR: 3.761(95% n CI: 1.092~12.955)和3.668(95% n CI：1.068~12.571)、6.173(95% n CI: 1.431~16.322)、5.162(95% n CI: 1.200~22.199)，均n P<0.05]。n 结论:治疗前n 18F-FDG PET/CT显像中MTV和TLG是影响老年cHL患者PFS和OS的独立危险因素，对老年cHL患者的预后判断具有一定的参考价值。n “,”Objective:To investigate the prognostic value of pretreatment n 18F-FDG PET/CT metabolic parameters in patients with elderly classical Hodgkin′s lymphoma (cHL).n Methods:From April 2011 to April 2020, the pretreatment clinical and n 18F-FDG PET/CT metabolic parameters of 42 elderly cHL patients (29 males and 13 females, median age 69 years) pathologically confirmed in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were obtained with 41%SUVn max as the threshold. ROC curve analysis was applied to obtain the best prognostic cut-off value of SUVn max, MTV and TLG. Kaplan-Meier method and log-rank test were used for univariate survival analysis, and Cox proportional hazard regression model was used for multivariate survival analysis.n Results:SUVn max, MTV and TLG of 42 elderly cHL patients were 16.49(12.24, 23.59), 79.29(26.29, 184.51) ml and 729.02(206.03, 2 073.98) g, respectively. ROC curve showed that the AUCs of SUVn max, MTV and TLG were 0.425, 0.882 and 0.832, respectively, and the best prognostic cut-off values were 16.49, 82.38 ml and 556.26 g, respectively. Univariate analysis showed that age, B symptoms, lactate dehydrogenase (LDH) level, Hb content, Ann Arbor stage, German Hodgkin Study Group (GHSG) score, MTV and TLG were relative factors affecting progression-free survival (PFS) rate (n χ2 values: 4.50-12.60, all n P<0.05), and age, B symptoms, LDH level, Ann Arbor stage, GHSG score, MTV and TLG were relative factors affecting overall survival (OS) rate (n χ2 values: 5.20-11.17, all n P<0.05). Multivariate analysis showed that MTV (relative risk (n RR)=5.370, 95% n CI: 1.697-16.277) and TLG (n RR=4.854, 95% n CI: 1.228-23.352) were independent prognostic predictors of PFS rate (both n P<0.05), and GHSG score (n RR=3.761, 95% n CI: 1.092-12.955; n RR=3.668, 95% n CI: 1.068-12.571), MTV (n RR=6.173, 95% n CI: 1.431-16.322) and TLG (n RR=5.162, 95% n CI: 1.200-22.199) were independent prognostic predictors of OS rate (all n P<0.05).n Conclusion:MTV and TLG in pretreatment n 18F-FDG PET/CT are independent prognostic factors for predicting PFS and OS in patients with elderly cHL patients, which have certainly reference value for prognosis.n