| 李可心,孙洪赞,辛军,郭启勇.18F-FDG PET/CT代谢参数预测早期宫颈癌盆腔淋巴结转移[J].中国医学影像技术,2018,34(10):1532~1535 |
| 18F-FDG PET/CT代谢参数预测早期宫颈癌盆腔淋巴结转移 |
| Prediction of metabolic parameters of 18F-FDG PET/CT in early-stage cervical cancer for pelvic lymph node metastasis |
| 投稿时间：2018-02-27 修订日期：2018-07-09 |
| DOI：10.13929/j.1003-3289.201802109 |
| 中文关键词: 宫颈肿瘤 淋巴结 正电子发射型体层摄影术 |
| 英文关键词:Uterine cervical neoplasms Lymph nodes Positron-emission tomography |
| 基金项目:辽宁省重点研发计划指导计划项目（2017225012）、辽宁省教育厅重点实验室基础研究项目（LZ2015079）。 |
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| 中文摘要: |
| 目的 探讨18F-FDG PET/CT显像代谢参数预测早期宫颈癌盆腔淋巴结转移的价值。方法 回顾性分析接受盆腔淋巴结清扫术的国际妇产科联盟（FIGO）分期为Ⅰa~Ⅱa期的286例宫颈癌患者的PET/CT资料，计算PET/CT诊断淋巴结转移的准确率、灵敏度及特异度，测量原发肿瘤病灶的PET/CT代谢参数：最大标准摄取值（SUVmax）、平均标准摄取值（SUVmean）、糖酵解总量（TLG）及肿瘤代谢体积（MTV）。比较淋巴结转移与无淋巴结转移患者间代谢参数的差异，并对有统计学意义的参数联合PET/CT诊断结果进行多因素分析，获得联合预测模型，绘制联合预测模型诊断淋巴结转移的ROC曲线，计算曲线下面积（AUC），并与PET/CT诊断结果进行比较。结果 286例中，病理证实淋巴结转移63例（淋巴结转移组），无转移223例（无淋巴结转移组），2组间原发灶TLG、MTV差异有统计学意义（P均<0.05），SUVmax、SUVmean差异无统计学意义（P均>0.05）。多因素分析显示，原发灶TLG、MTV及PET/CT诊断结果均是早期宫颈癌盆腔淋巴结转移的独立危险因素，联合预测模型诊断淋巴结转移的ROC曲线的AUC为0.805（P<0.05），优于PET/CT定性诊断（Z=3.044，P=0.002），后者的AUC为0.717。结论 18F-FDG PET/CT早期宫颈癌代谢参数TLG、MTV联合PET/CT定性诊断结果预测盆腔淋巴结转移具有一定价值，高于传统PET/CT定性诊断。 |
| 英文摘要: |
| Objective To explore the predictive value of 18F-FDG PET/CT for pelvic lymph node (PLN) metastasis in patients with early-stage cervical cancers. Methods Totally 286 patients with International Federation of Gynecology and Obstetrics (FIGO) stages of Ⅰa toⅡa cervical cancer underwent pelvic lymphadenectomy were enrolled. The accuracy, sensitivity and specificity of PET/CT in diagnosis of lymph node metastasis were calculated. The metabolic parameters of maximum and mean of standard uptake value (SUVmax, SUVmean), the total lesion glycolysis (TLG) and metabolic tumor volume (MTV) were measured. The differences of metabolic parameters between patients with and without lymph node metastasis were compared. Multivariate Logistic regression analysis was performed with statistically significant variables and PET/CT diagnosis results. Combination prediction model was constructed, and the ROC curve was drawn. The difference of area under curve (AUC) between combination predict model and PET/CT was compared. Results In all 286 patients, 63 were found with PLN metastases (PLN metastasis group), while 223 without (no PLN metastases group). TLG and MTV had significant differences (both P<0.05), while SUVmax and SUVmean had no significant differences (both P>0.05) between the two groups. Multivariate Logistic regression analysis displayed that TLG, MTV and PET/CT diagnostic results were the independent predictors of PLN metastasis (P<0.05). AUC of combination prediction model was 0.805 (P<0.05), better than that of PET/CT qualitative diagnosis (AUC=0.717, Z=3.044, P=0.002). Conclusion Combination of 18F-FDG PET/CT metabolic parameters of early-stage cervical cancer with qualitative diagnosis has certain value in prediction of PLN metastasis, higher than that of qualitative diagnosis of conventional PET/CT. |
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