Epstein-Barr 病毒 (EBV) 相关的噬血细胞性淋巴组织细胞增多症 (HLH) 导致的过度炎症和淋巴组织增生影响 18F-FDG PET/CT 对淋巴瘤的检测。我们的目的是通过结合实验室参数来提高 18F-FDG PET/CT 的诊断能力。这项回顾性研究涉及 46 名诊断为 EBV 阳性 HLH 的患者，他们在 4 年时间内开始化疗前接受了 18F-FDG PET/CT。这些患者被分为两组：EBV 相关 HLH (EBV-HLH) (n = 31) 和 EBV 阳性淋巴瘤相关 HLH (EBV  LA-HLH) (n = 15)。我们采用多变量逻辑回归和回归树分析来开发诊断模型，并评估其在诊断和预后中的功效。结合 SUVmax 比率、血浆 EBV-DNA 拷贝数和 IFN-γ 的列线图达到 100% 的敏感性和 81.8% 的特异性， AUC 为 0.926（95%CI，0.779-0.988）。重要的是，该列线图还证明了 EBV-HLH 患者死亡率的预测能力，风险比为 4.2（95% CI，1.1-16.5）。通过列线图识别的高危EBV-HLH患者与淋巴瘤患者的预后相似。研究发现，在活动性EBV感染患者中，单独使用18F-FDG PET/CT区分淋巴瘤和EBV-HLH存在局限性，列线图的整合显着提高了诊断准确性，并且还表现出与预后结果的密切相关性。© 2024。作者。

The hyperinflammatory condition and lymphoproliferation due to Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH) affect the detection of lymphomas by 18F-FDG PET/CT. We aimed to improve the diagnostic capabilities of 18F-FDG PET/CT by combining laboratory parameters.This retrospective study involved 46 patients diagnosed with EBV-positive HLH, who underwent 18F-FDG PET/CT before beginning chemotherapy within a 4-year timeframe. These patients were categorized into two groups: EBV-associated HLH (EBV-HLH) (n = 31) and EBV-positive lymphoma-associated HLH (EBV + LA-HLH) (n = 15). We employed multivariable logistic regression and regression tree analysis to develop diagnostic models and assessed their efficacy in diagnosis and prognosis.A nomogram combining the SUVmax ratio, copies of plasma EBV-DNA, and IFN-γ reached 100% sensitivity and 81.8% specificity, with an AUC of 0.926 (95%CI, 0.779-0.988). Importantly, this nomogram also demonstrated predictive power for mortality in EBV-HLH patients, with a hazard ratio of 4.2 (95%CI, 1.1-16.5). The high-risk EBV-HLH patients identified by the nomogram had a similarly unfavorable prognosis as patients with lymphoma.The study found that while 18F-FDG PET/CT alone has limitations in differentiating between lymphoma and EBV-HLH in patients with active EBV infection, the integration of a nomogram significantly improves the diagnostic accuracy and also exhibits a strong association with prognostic outcomes.© 2024. The Author(s).