Division of Cancer Center, Hokkaido University Hospital, Kita-15, Nishi-7, Kita-ku, Sapporo, Japan.
Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan.
Int J Clin Oncol. 2022 Nov;27(11):1780-1790. doi: 10.1007/s10147-022-02235-4. Epub 2022 Aug 30.
Sinusoidal obstruction syndrome (SOS) refers to liver injury caused by hematopoietic stem cell transplantation (HSCT) and anticancer drugs including oxaliplatin. Increased splenic volume (SV) on computed tomography (CT) indicates oxaliplatin-induced SOS. Similarly, ultrasonography and liver stiffness measurement (LSM) by shear-wave elastography (SWE) can help diagnose SOS after HSCT; however, their usefulness for diagnosing oxaliplatin-induced SOS remains unclear. We investigated the usefulness of the Hokkaido ultrasonography-based scoring system with 10 ultrasonographic parameters (HokUS-10) and SWE in diagnosing oxaliplatin-induced SOS early.
In this prospective observational study, ultrasonography and SWE were performed before and at 2, 4, and 6 months after oxaliplatin-based chemotherapy. HokUS-10 was used for assessment. CT volumetry of the SV was performed in clinical practice, and an SV increase ≥ 30% was considered the diagnostic indicator of oxaliplatin-induced SOS. We assessed whether HokUS-10 and SWE can lead to an early detection of oxaliplatin-induced SOS before an increased SV on CT.
Of the 30 enrolled patients with gastrointestinal cancers, 12 (40.0%) with an SV increase ≥ 30% on CT were diagnosed with SOS. The HokUS-10 score was not correlated with an SV increase ≥ 30% (r = 0.18). The change in rate of three HokUS-10 parameters were correlated with an SV increase ≥ 30% (r = 0.32-0.41). The change in rate of LSM by SWE was correlated with an SV increase ≥ 30% (r = 0.40).
The usefulness of HokUS-10 score was not demonstrated; however, some HokUS-10 parameters and SWE could be useful for the early diagnosis of oxaliplatin-induced SOS.
窦状隙阻塞综合征（SOS）是指造血干细胞移植（HSCT）和包括奥沙利铂在内的抗癌药物引起的肝损伤。CT 上脾脏体积（SV）增加表明奥沙利铂诱导的 SOS。同样，超声和剪切波弹性成像（SWE）的肝硬度测量（LSM）可帮助诊断 HSCT 后的 SOS；然而，它们在诊断奥沙利铂诱导的 SOS 中的作用尚不清楚。我们研究了基于北海道超声的评分系统（HokUS-10）和 SWE 在早期诊断奥沙利铂诱导的 SOS 中的应用。
在这项前瞻性观察研究中，在奥沙利铂化疗前和化疗后 2、4 和 6 个月进行超声和 SWE。采用 HokUS-10 进行评估。SV 的 CT 体积在临床实践中进行，SV 增加≥30%被认为是奥沙利铂诱导的 SOS 的诊断指标。我们评估了 HokUS-10 和 SWE 是否可以在 CT 上 SV 增加之前更早地检测奥沙利铂诱导的 SOS。
在 30 名胃肠道癌症患者中，12 名（40.0%）CT 上 SV 增加≥30%的患者被诊断为 SOS。HokUS-10 评分与 SV 增加≥30%无相关性（r=0.18）。三个 HokUS-10 参数的变化率与 SV 增加≥30%相关（r=0.32-0.41）。SWE 的 LSM 变化率与 SV 增加≥30%相关（r=0.40）。
HokUS-10 评分的实用性未得到证实；然而，一些 HokUS-10 参数和 SWE 可能对奥沙利铂诱导的 SOS 的早期诊断有用。
