Fukumoto Ami, Honma Koichi, Nakaminato Shuichiro, Kitaura Koichi, Ikeda Daisuke, Uesugi Yuka, Tabata Rikako, Miura Daisuke, Narita Kentaro, Takeuchi Masami, Matsue Kosei
Department of Hematology/Oncology, Kameda Medical Center, Chiba, Japan.
Department of Clinical Pathology, Kameda Medical Center, Chiba, Japan.
Transplant Cell Ther. 2023 Oct;29(10):639.e1-639.e4. doi: 10.1016/j.jtct.2023.06.023. Epub 2023 Jul 7.
The aim of this study was to evaluate the concordance between clinical diagnosis and pathologic findings of veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) in post-hematopoietic stem cell transplantation recipients and to investigate the accuracy of the HOKUS-10 score in diagnosing VOD/SOS. We included 13 patients who underwent transjugular liver biopsy for clinical suspicion of VOD/SOS and collected their clinical, laboratory, imaging, and pathologic data. Eleven patients were confirmed to have VOD/SOS by pathologic examination. The median HokUS-10 score and hepatic venous pressure gradient were 6 points (range, 0 to 10 points) and 13 mmHg (range, 7 to 24 mmHg), respectively. There was no significant difference between these scores in VOD/SOS and non-VOD/SOS cases; however, patients with lower HokUS-10 scores tended to have milder histologic features of VOD/SOS compared with severe cases. This study highlights the potential discordance between clinical diagnosis and pathologic diagnosis of VOD/SOS and emphasizes the importance of liver biopsy to optimize treatment.
本研究的目的是评估造血干细胞移植受者静脉闭塞性疾病/窦性阻塞综合征（VOD/SOS）的临床诊断与病理结果之间的一致性，并研究HOKUS-10评分在诊断VOD/SOS中的准确性。我们纳入了13例因临床怀疑VOD/SOS而接受经颈静脉肝活检的患者，并收集了他们的临床、实验室、影像学和病理数据。11例患者经病理检查确诊为VOD/SOS。HokUS-10评分中位数和肝静脉压力梯度分别为6分（范围0至10分）和13 mmHg（范围7至24 mmHg）。VOD/SOS病例和非VOD/SOS病例的这些评分之间无显著差异；然而，与重症病例相比，HokUS-10评分较低的患者VOD/SOS的组织学特征往往较轻。本研究强调了VOD/SOS临床诊断与病理诊断之间可能存在的不一致性，并强调了肝活检对优化治疗的重要性。
