Furtner Julia, Nenning Karl-Heinz, Roetzer Thomas, Gesperger Johanna, Seebrecht Lukas, Weber Michael, Grams Astrid, Leber Stefan L, Marhold Franz, Sherif Camillo, Trenkler Johannes, Kiesel Barbara, Widhalm Georg, Asenbaum Ulrika, Woitek Ramona, Berghoff Anna S, Prayer Daniela, Langs Georg, Preusser Matthias, Wöhrer Adelheid
Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria.
Computational Imaging Research Lab, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria.
Cancers (Basel). 2021 Feb 2;13(3):566. doi: 10.3390/cancers13030566.
In this study, we assessed the prognostic relevance of temporal muscle thickness (TMT), likely reflecting patient's frailty, in patients with primary central nervous system lymphoma (PCNSL). In 128 newly diagnosed PCNSL patients TMT was analyzed on cranial magnetic resonance images. Predefined sex-specific TMT cutoff values were used to categorize the patient cohort. Survival analyses, using a log-rank test as well as Cox models adjusted for further prognostic parameters, were performed. The risk of death was significantly increased for PCNSL patients with reduced muscle thickness (hazard ratio of 3.189, 95% CI: 2-097-4.848, < 0.001). Importantly, the results confirmed that TMT could be used as an independent prognostic marker upon multivariate Cox modeling (hazard ratio of 2.504, 95% CI: 1.608-3.911, < 0.001) adjusting for sex, age at time of diagnosis, deep brain involvement of the PCNSL lesions, Eastern Cooperative Oncology Group (ECOG) performance status, and methotrexate-based chemotherapy. A TMT value below the sex-related cutoff value at the time of diagnosis is an independent adverse marker in patients with PCNSL. Thus, our results suggest the systematic inclusion of TMT in further translational and clinical studies designed to help validate its role as a prognostic biomarker.
在本研究中，我们评估了颞肌厚度（TMT）在原发性中枢神经系统淋巴瘤（PCNSL）患者中的预后相关性，TMT可能反映了患者的虚弱程度。对128例新诊断的PCNSL患者的头颅磁共振图像进行了TMT分析。使用预先定义的性别特异性TMT临界值对患者队列进行分类。采用对数秩检验以及针对其他预后参数进行调整的Cox模型进行生存分析。肌肉厚度降低的PCNSL患者死亡风险显著增加（风险比为3.189，95%置信区间：2.097 - 4.848，P < 0.001）。重要的是，结果证实，在对性别、诊断时年龄、PCNSL病变的脑深部受累情况、东部肿瘤协作组（ECOG）体能状态和基于甲氨蝶呤的化疗进行调整后，多变量Cox建模显示TMT可作为独立的预后标志物（风险比为2.504，95%置信区间：1.608 - 3.911，P < 0.001）。诊断时TMT值低于性别相关临界值是PCNSL患者的独立不良标志物。因此，我们的结果表明，在进一步的转化和临床研究中应系统纳入TMT，以帮助验证其作为预后生物标志物的作用。
