Prognostički značaj metaboličkih tumorskih parametara na inicijalnom FDG-PET/CT kod bolesnika sa izolovanim infradijafragmalnim Hočkinovim limfomom
Sažetak
Uvod/Cilj. Prisustvo izolovanih infradijafragmalnih limfnih čvorova kod Hočkinovog limfoma (HL) nije često i javlja se kod 5–15% svih HL I-II stadijuma. Važni podaci o prognostičkim faktorima i optimalnom lečenju izolovanog infradijafragmalnog HL (IIHL) nisu jasno definisani. Cilj ovog ispitivanja bila je procena prognostičke vrednosti pokazatelja metabolizma tumora na inicijalnom pregledu pomoću 18-fluorodeoksiglukoza-pozitron emisione tomografije /kompjuterizovane tomografije (FDG-PET/CT) preko kvanititativnih PET/CT parametara zajedno sa klasičnim predefinisanim faktorima rizika za bolesnike sa II HL.
Metode. U ovu retrospektivnu kohortnu studiju, sprovedenu između 2004. i 2015. godine, bio je uključen 21 bolesnik, kod kojih je za određenjivanje primarnog stadijuma bolesti primenjena FDG-PET/CT. Kvantitativni PET/CT parametri [vrednost maksimalnog standardizovanog preuzimanja (maximum standardized uptake value – SUVmax), prosečna vrednost standardizovanog preuzimanja (mean standardized uptake value – SUVmean), metabolički volumen tumora (metabolic tumor valume – MTV), ukupna glikoliza u lezijama (total lesion glycolysis – TLG)] korišćeni su za procenu preživljavanja bez prisustva bolesti (disease-free survival – DFS) i sveukupnog preživljavanja (overall survival – OS). Rezultati. Izvršena je univarijantna Cox-ova regresiona analiza svih potencijalnih faktora rizika koji imaju uticaj na metastaze/recidiv bolesti. Faktori koji su imali vrednost p < 0,2 posle izvršene univarijante analize (pol, dob, stadijum bolesti, raširena bolest (bulky disease), SUVmax, SUVmean, MTV, TLG), potom su obrađeni u multivarijantnom regresionom modelu. Posle multivarijantne regresione analize pol, TLG i raširena bolest prepoznati su kao statistički značajni faktori rizika za prognozu bolesti kod bolesnika sa IIHL. Zaključak. Prisustvo raširene bolesti u momentu postavljanja dijagnoze i visoka vrednost TLG kod određivanja primarnog stadijuma bolesti pomoću FDG-PET/CT su potencijalni faktori rizika i za DFS i OS kod bolesnika sa IIHL.
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