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低剂量全身 CT 诊断能否反映全身性肥大细胞增多症的骨髓表现?

Can Diagnostic Low-dose Whole-body CT Reflect Bone Marrow Findings in Systemic Mastocytosis?

机构信息

Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany

Department of Hematology and Oncology, University of Leipzig, Leipzig, Germany.

出版信息

Anticancer Res. 2020 Feb;40(2):1015-1022. doi: 10.21873/anticanres.14036.

Abstract

BACKGROUND/AIM: Systemic mastocytosis (SM) is a heterogeneous hematological entity, characterized by the proliferation of mast cells, commonly involving the skeleton. The present study sought to elucidate whether the computed tomographic (CT) number as Hounsfield units (HU) derived from whole-body CT is associated with bone marrow findings in SM.

PATIENTS AND METHODS

Patient records of the local Oncology and Hematology Department from 2007 to 2018 were screened for patients with SM. Total 16 patients [five female (31.2%)] with a mean age of 55.7±10.3 years were included in the present retrospective study. KIT mutation; tryptase, alkaline phosphatase, and calcium level in serum; and the proportion of mast cells, and CD2, CD25- and CD117-positive cells in bone marrow biopsies were evaluated.

RESULTS

HU correlated with serum calcium level (r=-0.51, p=0.04), mast cell proportion (r=0.66, p=0.01) and with the proportion of CD117-positive cells in bone marrow biopsy (r=0.56, p=0.04). In the group with aggressive SM, the mean HU value was statistically significantly higher than that of the indolent title:group [245±127 (range=100-451) vs. 121±16 (range=90-135), respectively, p=0.04].

CONCLUSION

The present study identified that the HU value derived from low-dose CT was associated with mast cell infiltration in bone marrow in SM and with the proportion of CD117-positive cells. Further studies are needed to determine whether the measurement of the HU value has prognostic implications in SM and can be used as a reliable biomarker in this disease.

摘要

背景/目的:系统性肥大细胞增多症(SM)是一种异质性血液病,其特征为肥大细胞增殖,通常累及骨骼。本研究旨在阐明全身 CT 获得的 CT 数(以亨氏单位[HU]表示)是否与 SM 中的骨髓发现相关。

患者和方法

对 2007 年至 2018 年当地肿瘤学和血液科的患者记录进行筛选,以寻找 SM 患者。本回顾性研究共纳入 16 例患者[女性 5 例(31.2%)],平均年龄为 55.7±10.3 岁。评估 KIT 突变;血清中类胰蛋白酶、碱性磷酸酶和钙水平;骨髓活检中肥大细胞比例,以及 CD2、CD25-和 CD117 阳性细胞的比例。

结果

HU 与血清钙水平呈负相关(r=-0.51,p=0.04),与骨髓活检中肥大细胞比例(r=0.66,p=0.01)和 CD117 阳性细胞比例呈正相关(r=0.56,p=0.04)。在侵袭性 SM 组中,平均 HU 值明显高于惰性 SM 组[245±127(范围=100-451)比 121±16(范围=90-135),p=0.04]。

结论

本研究发现,低剂量 CT 获得的 HU 值与 SM 骨髓中肥大细胞浸润以及 CD117 阳性细胞比例相关。需要进一步的研究来确定 HU 值的测量是否对 SM 具有预后意义,并且可以作为该疾病的可靠生物标志物。

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