■有证据表明淋巴瘤的代谢疾病负担会影响患者的预后。然而,疾病严重程度对心血管系统的影响尚不清楚.
■本研究的目的是通过研究疾病代谢负荷与动脉氟脱氧葡萄糖(FDG)摄取之间的关系来检查淋巴瘤是否与动脉炎症有关。
■将62名患有活动性霍奇金淋巴瘤或非霍奇金淋巴瘤的未接受化疗的患者与先前接受过治疗且没有活动性疾病的淋巴瘤患者的个体对照组相匹配(2:1)。所有组均接受18F-FDG位置发射断层扫描-计算机断层扫描成像。疾病严重程度通过代谢性肿瘤体积(MTV)和总病变糖酵解量化,对应于淋巴瘤区域内最大SUV的标准化摄取值(SUV)≥41%或≥2.5。和主动脉FDG摄取通过靶-背景比(TBR)进行定量。还测量了炎症和疾病严重程度的生物标志物。
■MTV和总病变糖酵解测量值与炎症和疾病生物标志物显著相关。与对照组相比,活动性非霍奇金淋巴瘤患者的主动脉TBR更高(中位数差异0.51;95%置信区间[CI]:0.28至0.78;p<0.001)。同样,与对照组相比,活动性霍奇金淋巴瘤患者的主动脉TBR值较高(中位差异0.31;95%CI:0.15~0.49;p<0.001).此外,与I至II期患者相比,III至IV期患者的主动脉TBR略有增加(中位主动脉TBR:2.23[四分位距:2.01至2.54]vs.2.06[四分位数间距:1.83至2.27;p=0.050)。在多变量分析中,主动脉FDG摄取和MTV≥2.5值独立相关(β=0.425;95%CI:0.189至0.662;p=0.001;R2=0.208),主动脉FDG摄取和MTV≥41%(β=0.407;95%CI:0.167~0.649,p=0.001;R2=0.191).
■主动脉壁FDG摄取与指示淋巴瘤可能的血管效应的疾病严重程度相关。这项工作强调了分子成像在心脏肿瘤学中评估疾病严重程度及其对脉管系统的影响的新潜在作用。
UNASSIGNED: There is evidence that metabolic disease burden in lymphoma influences patient outcome. However, the impact of disease severity on the cardiovascular system is unknown.
UNASSIGNED: The aim of this study was to examine whether lymphoma is associated with arterial inflammation by investigating the relationship between disease metabolic burden and arterial fluorodeoxyglucose (FDG) uptake.
UNASSIGNED: Sixty-two chemotherapy-naïve patients with active Hodgkin\'s or non-Hodgkin\'s lymphoma were matched (2:1) to individual control groups of lymphoma patients previously treated and free of active disease. All groups underwent 18F-FDG position emission tomography-computed tomography imaging. Disease severity was quantified by metabolic tumor volume (MTV) and total lesion glycolysis corresponding to standardized uptake values (SUVs) ≥41% or ≥2.5 of the maximum SUV within lymphoma regions, and aortic FDG uptake was quantified through the target-to-background ratio (TBR). Inflammatory and disease severity biomarkers were also measured.
UNASSIGNED: MTV and total lesion glycolysis measurements were significantly correlated with inflammatory and disease biomarkers. Aortic TBR was higher in patients with active non-Hodgkin\'s lymphoma compared with control subjects (median difference 0.51; 95% confidence interval [CI]: 0.28 to 0.78; p < 0.001). Similarly, patients with active Hodgkin\'s lymphoma had higher values of aortic TBR compared with control subjects (median difference 0.31; 95% CI: 0.15 to 0.49; p < 0.001). In addition, aortic TBR was modestly increased in patients with stage III to IV disease compared with those with stage I to II disease (median aortic TBR: 2.23 [interquartile range: 2.01 to 2.54] vs. 2.06 [interquartile range: 1.83 to 2.27; p = 0.050). In multivariable analysis, aortic FDG uptake and MTV≥2.5 values were independently associated (β = 0.425; 95% CI: 0.189 to 0.662; p = 0.001; R2 = 0.208), as were aortic FDG uptake and MTV≥41% (β = 0.407; 95% CI: 0.167 to 0.649, p = 0.001; R2 = 0.191).
UNASSIGNED: Aortic wall FDG uptake is related with disease severity indicative of a possible vascular effect of lymphoma. This work highlights a new potential role of molecular imaging in cardio-oncology for evaluating disease severity and its consequences on the vasculature.