Türk İlteriş, Çetin Mehmet, Solak Necati, Kayaaslan Ali Can, Gürçay Nesrin, Tatcı Ebru, Fındık Göktürk, Bıçakçıoğlu Pınar, Gülhan Selim Şakir Erkmen
Department of Thoracic Surgery, University of Health Sciences, Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye.
Pınarbaşı Mah. Sanatoryum Cad. Atatürk Sanatoryum EAH B Blok2., Kat Göğüs Cerrahisi Kliniği, Ankara, Keçiören, Türkiye.
BMC Pulm Med. 2025 Jul 4;25(1):324. doi: 10.1186/s12890-025-03709-7.
Several studies have been conducted to identify the parameters associated with the aggressive course of pleuropulmonary solitary fibrous tumors (SFT) following surgical treatment, and various classification systems have been proposed for assessing risk.
The surgical outcomes of patients with pleuropulmonary SFT who underwent surgery between 2009 and 2024 at our center were retrospectively evaluated. Parameters of patients who experienced recurrence during follow-up were analyzed, and the risk classification systems proposed by Demicco were tested on our patient cohort. The pozitron emision tomography/ computed tomography (PET/CT) standart uptake value(SUVmax), which was significantly associated with recurrence, was incorporated into the modified Demicco classification, and a new classification model was developed and compared with existing models.
Among the 79 included patients, 21.5% had intraparenchymal tumors, which were excised along with various parenchymal resections, while pleural tumors underwent mass excision. The postoperative follow-up period was 108.16 ± 44.09 months, during which 7.6% of patients experienced recurrence. Tumor size (p = 0.023), mitotic index (p < 0.001), presence of necrosis (p = 0.007), and PET/CT SUVmax value (p = 0.005) were found to be significantly associated with recurrence. The PET/CT SUVmax value, which was not included in Demicco's classifications, ranged from 1.12 to 7.98, with a cutoff value of 4.50. The addition of SUVmax to the modified Demicco classification categorized all patients with recurrence into the high-risk group, and the new classification model strongly differentiated recurrence (p < 0.01, 100% sensitivity, 71.43% specificity).
The incorporation of SUVmax into the modified Demicco classification system for pleuropulmonary SFT provides a more significant prediction of recurrence.
已经开展了多项研究来确定与胸膜肺孤立性纤维瘤（SFT）手术治疗后侵袭性病程相关的参数，并提出了各种风险评估分类系统。
回顾性评估2009年至2024年在本中心接受手术的胸膜肺SFT患者的手术结果。分析随访期间出现复发的患者的参数，并在我们的患者队列中测试Demicco提出的风险分类系统。将与复发显著相关的正电子发射断层扫描/计算机断层扫描（PET/CT）标准摄取值（SUVmax）纳入改良的Demicco分类，开发了一种新的分类模型并与现有模型进行比较。
在纳入的79例患者中，21.5%患有实质内肿瘤，与各种实质切除术一起切除，而胸膜肿瘤则进行肿块切除术。术后随访期为108.16±44.09个月，在此期间7.6%的患者出现复发。发现肿瘤大小（p = 0.023）、有丝分裂指数（p < 0.001）、坏死的存在（p = 0.007）和PET/CT SUVmax值（p = 0.005）与复发显著相关。未纳入Demicco分类的PET/CT SUVmax值范围为1.12至7.98，临界值为4.50。将SUVmax添加到改良的Demicco分类中，将所有复发患者归类为高风险组，新的分类模型对复发有很强的区分能力（p < 0.01，敏感性100%，特异性71.43%）。
将SUVmax纳入胸膜肺SFT的改良Demicco分类系统可对复发提供更显著的预测。
