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Can systemic immune inflammatory index beat 18F-FDG PET-CT in identifying breast cancer patients with increased risk of vascular disease?
Session:
Sessão de Posters 11 - Miocardite Aguda
Speaker:
Rafaela Fernandes
Congress:
CPC 2024
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.4 Myocardial Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Rafaela Fernandes; João Borges-Rosa; Rodolfo Silva; Joana Moura Ferreira; Manuel Oliveira-Santos; Mariana Simões; Eric Monteiro; Gracinda Costa; Lino Gonçalves; Maria João Vidigal-Ferreira
Abstract
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background</strong>: Cancer is a well-known pro-inflammatory state. We hypothesized that systemic inflammation could be proportional to tumour 18[F] Fluorodeoxyglucose (<sup>18</sup>F-FDG) PET-CT uptake and correlate to vascular inflammatory activity. </span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong>: Single-centre retrospective observational study of consecutive women with breast cancer (BC). Patients had to be under 55 years, performed <sup>18</sup>F-FDG PET-CT before treatment and between 2018 and 2021. The purpose was to evaluate if systemic immune inflammatory (SII) index could be a non-invasive screening marker in BC patients, helping clinicians to identify patients at higher risk of developing vascular disease. SII index was calculated by the ratio of neutrophil-to-platelet and lymphocyte counts at cancer diagnosis. <sup>18</sup>F-FDG vascular uptake was acquired as tissue-to-background ratio (TBR) by measuring maximum standard uptake value (SUV) in the aorta and correcting it to right atrial mean SUV. Tumour uptake was obtained as MTV and total lesion glycolysis (TLG) was the product of MTV and tumour medium SUV. Data was collected through revision of informatized clinical files. Statistical analysis used Kolmogorov-Smirnov test to assess normality, Student T test or non-parametric equivalent tests for continuous variables, correlation and regression models. </span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: 45 women were enrolled. Mean age was 43.3<span style="font-family:Symbol">±</span>7.59 years, most had no baseline CVRF (35/81.4%). Mean follow-up time was 47<span style="font-family:Symbol">±</span>14.9 months. All-cause mortality was 22.2% (n=10), with no cardiovascular (CV) mortality or significant CV events. Median SII index was 545.3<span style="font-family:Symbol">±</span>818.6 x 10<sup>9</sup> cells/L. SII index was not influenced by baseline CVRF, and it does not correlate with MTV or aortic TBR. A positive correlation was established between aortic mean TBR and MTV (<span style="font-family:Symbol">r</span>=0.318, <em>p-value</em>=0.040) due to abdominal aortic TBR (<span style="font-family:Symbol">r</span>=0.507, <em>p-value</em>=0.001). A linear regression model was applied which translated that for every 1cm<sup>3</sup> increase in MTV, abdominal aortic TBR increases by 0.001 (<em>p-value</em>=0.047). This was not influenced by baseline CVRF. </span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong>: SII index does not correlate with either MTV or aortic TBR. Correlation between MTV and abdominal aortic TBR could indicate a risk for vascular disease. Therefore, SII index lacks the power that <sup>18</sup>F-FDG abdominal aortic uptake in PET-CT may have to potentially be a surrogate marker for vascular disease in BC cancer patients. </span></span></span></p>
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