Prognostic value of the pre-treatment SUVmax of ¹⁸ F-FDG PET/CT combined with peripheral absolute lymphocyte in patients with newly diagnosed extranodal natural killer/T-cell lymphoma.

Cancer imaging : the official publication of the International Cancer Imaging Society [Cancer Imaging] 2025 Jun 04; Vol. 25 (1), pp. 67. Date of Electronic Publication: 2025 Jun 04.

Competing Interests: Declarations. Ethics approval and consent to participate: This study was authorized by the Ethics Committee for Clinical Research (ECCR) of the First Affiliated Hospital of Wenzhou Medical University. The ECCR waived this retrospective study informed consent (No. KY2021-R081). Consent for publication: All authors consent to the publication of this manuscript. Competing interests: The authors declare no competing interests.
Background: Accurate assessment and prediction of patient prognosis, early identification of high-risk patients, and improvement of clinical outcomes for individuals with extranodal natural killer/T-cell lymphoma (ENKTCL) are critical. This study evaluates the prognostic value of a novel model combining maximum standardized uptake value (SUVmax) and absolute lymphocyte count (ALC) in ENKTCL patients.
Methods: We conducted a retrospective analysis of clinical data from 57 patients diagnosed with primary ENKTCL. Optimal cut-off values for SUVmax and ALC were determined using receiver operating characteristic (ROC) curves. Clinical characteristics were analyzed by Chi-squared tests or Fisher's exact tests. Survival analysis was performed using the Kaplan-Meier method and log-rank test, while independent prognostic factors were identified through Cox regression analysis.
Results: The optimal cut-off values for SUVmax and ALC were established at 11.8 and 0.87 × 10 ⁹ /L, respectively. Univariate and multivariate analyses confirmed that both SUVmax and ALC were independent predictors of prognosis in ENKTCL patients. According to the combined SUVmax-ALC model, the patients were stratified into low-risk, intermediate-risk and high-risk groups. Kaplan-Meier analysis revealed significant differences in overall survival (OS) and progression-free survival (PFS) among these groups (p < 0.001). ROC curve analysis showed that the area under the curve (AUC) for the SUVmax-ALC model was 0.714, superior to individual tests (SUVmax, AUC = 0.674; ALC, AUC = 0.589). In addition, the AUC of the SUVmax-ALC model was higher than the International Prognostic Index (IPI, AUC = 0.632), nomogram-revised risk index (NRI, AUC = 0.566), and prognostic index of natural killer T-cell lymphoma (PINK, AUC = 0.592). Furthermore, the SUVmax-ALC model more effectively identified high-risk patients within low-risk IPI, PINK, or NRI groups, providing additional prognostic information. These findings indicate that the combination of SUVmax and ALC offers enhanced predictive accuracy for ENKTCL prognosis.
Conclusion: Pre-treatment SUVmax and ALC can serve as valuable indicators for predicting the prognosis of ENKTCL patients. Compared to IPI, NRI, and PINK scores, the SUVmax-ALC model demonstrates superior performance in risk stratification, suggesting its potential as an effective personalized prognostic tool for ENKTCL patients.
(© 2025. The Author(s).)

English

Publisher: Springer Nature Country of Publication: England NLM ID: 101172931 Publication Model: Electronic Cited Medium: Internet ISSN: 1470-7330 (Electronic) Linking ISSN: 14707330 NLM ISO Abbreviation: Cancer Imaging Subsets: MEDLINE

Lymphoma, Extranodal NK-T-Cell*/diagnostic imaging , Lymphoma, Extranodal NK-T-Cell*/blood , Lymphoma, Extranodal NK-T-Cell*/mortality , Lymphoma, Extranodal NK-T-Cell*/pathology , Positron Emission Tomography Computed Tomography*/methods , Fluorodeoxyglucose F18*, Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Prognosis ; Adult ; Lymphocyte Count ; Aged ; Radiopharmaceuticals ; ROC Curve

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