Bone mineral density in patients with systemic mastocytosis: correlations with clinical and histopathological features.

OBJECTIVES: Systemic mastocytosis (SM) is a heterogeneous haematological entity characterised by proliferation of mast cells. Skeletal abnormalities of SM include osteolysis, osteopenia and osteoporosis but also osteosclerosis. A routinely used modality to assess bone density is dual-energy x-ray absorptiometry (DXA). The present study sought to elucidate possible associations between DXA findings with both clinical and bone marrow biopsy findings in SM. METHODS: Patient records of the local oncology and haematology department from 2007 to 2018 were screened for patients with SM. Overall, 39 patients (18 women and 21 men) with sufficient DXA images and clinical data were identified. We evaluated cKit mutation, tryptase level in serum, alkaline phosphatase, calcium level in serum, haemoglobin level, leucocytes and thrombocytes. Bone marrow biopsies were also evaluated. RESULTS: There were no significant differences between the different bone marrow patterns and in regard of cKit mutations. Significant lower bone mineral density (BMD) - T-score and Z-score values were identified for the indolent type compared to aggressive type. Correlation analysis revealed an association between BMD and tryptase level (r=0.35, p=0.049), mast cell proportion in bone marrow biopsy (r=0.45, p=0.01) and with the years since diagnosis (r=-0.42, p=0.02). Moreover, the correlations differed between the indolent and aggressive type. CONCLUSIONS: DXA findings are associated with clinical and bone marrow biopsy parameters in SM. A positive association with tryptase level and mast cell amount in bone marrow biopsies was identified. This corroborates the usefulness of DXA in SM beyond the sole assessment of osteopenia and osteoporosis.

Can Diagnostic Low-dose Whole-body CT Reflect Bone Marrow Findings in Systemic Mastocytosis?

BACKGROUND/AIM: Systemic mastocytosis (SM) is a heterogeneous hematological entity, characterized by the proliferation of mast cells, commonly involving the skeleton. The present study sought to elucidate whether the computed tomographic (CT) number as Hounsfield units (HU) derived from whole-body CT is associated with bone marrow findings in SM. PATIENTS AND METHODS: Patient records of the local Oncology and Hematology Department from 2007 to 2018 were screened for patients with SM. Total 16 patients [five female (31.2%)] with a mean age of 55.7±10.3 years were included in the present retrospective study. KIT mutation; tryptase, alkaline phosphatase, and calcium level in serum; and the proportion of mast cells, and CD2, CD25- and CD117-positive cells in bone marrow biopsies were evaluated. RESULTS: HU correlated with serum calcium level (r=-0.51, p=0.04), mast cell proportion (r=0.66, p=0.01) and with the proportion of CD117-positive cells in bone marrow biopsy (r=0.56, p=0.04). In the group with aggressive SM, the mean HU value was statistically significantly higher than that of the indolent title:group [245±127 (range=100-451) vs. 121±16 (range=90-135), respectively, p=0.04]. CONCLUSION: The present study identified that the HU value derived from low-dose CT was associated with mast cell infiltration in bone marrow in SM and with the proportion of CD117-positive cells. Further studies are needed to determine whether the measurement of the HU value has prognostic implications in SM and can be used as a reliable biomarker in this disease.

Associations between FDG-PET and Ki 67-index in head and neck cancer: A meta-analysis.

BACKGROUND: FDG-PET might be able to reflect histopathology features of tumors. Ki 67 in head and neck carcinomas (HNSCC). The present study sought to elucidate the association between Ki 67 index and SUVmax based upon a large patient sample. METHODS: PubMed database was screened for studies analyzed the relationship between Ki 67 and SUV in HNSCC. Nine studies comprising 211 patients were suitable for analysis. RESULTS: SUVmax increased with tumor grade and was statistically significant different between G1, G2, and G3 tumors. The ROC analysis for discrimination between G1/G2 and G3 tumors revealed an area under curve of 0.71. In the overall patient sample, SUVmax correlated statistically significant with Ki 67 index (r = 0.154, P = .032). CONCLUSION: The present study identified a weak correlation between SUV values and proliferation index Ki 67 index in HNSCC in a large patient sample. Therefore, SUVmax cannot be used as surrogate parameter for proliferation activity in HNSCC.

Associations between whole tumor histogram analysis parameters derived from ADC maps and expression of EGFR, VEGF, Hif 1-alpha, Her-2 and Histone 3 in uterine cervical cancer.

OBJECTIVE: Diffusion weighted imaging (DWI) can be quantified by apparent diffusion coefficient (ADC) and can predict tissue microstructure. The aim of the present study was to analyze possible associations between ADC histogram based parameters with different histopathological parameters in cervical squamous cell carcinoma. MATERIALS AND METHODS: 18 female patients (age range 32-79 years) with squamous cell cervical carcinoma were retrospectively enrolled. In all cases, pelvic MRI was performed with a DWI (b-values 0 and 1000 s/mm2). Histogram analysis was performed as a whole lesion measurement. Histopathological parameters included expression of EGFR, VEGF, Hif1-alpha, Her2 and Histone 3. Spearman's correlation coefficient was used to analyze associations between investigated parameters. RESULTS: Analyze of the investigated ADC histogram parameters showed a good interreader variability, ranging from 0.705 for entropy to 0.959 for ADCmedian. EGFR expression correlated statistically significant with several histogram parameters. The highest correlation was observed for p75 (p = -0.562, P = 0.015). There were several correlations with histone 3, the highest with p25 (p = -0.610, P = 0.007). None of the ADC related parameters correlated statistically significant with expression of VEGF, Hif1-alpha and Her2. CONCLUSION: Histogram analysis showed a good interreader agreement. ADC histogram parameters might be able to reflect expression of EGFR and histone 3 in cervical squamous cell carcinomas, but not expression of VEGF, Hif1-alpha and Her2.