Lin Wu C, Hung Yao C, Yeh Lian S, Kao Chia H, Yen Ruoh F, Shen Yeh Y
Department of Obstetrics and Gynecology, China Medical College Hospital, Taichung, Taiwan.
Gynecol Oncol. 2003 Apr;89(1):73-6. doi: 10.1016/s0090-8258(03)00058-1.
In advanced cervical cancer, it has been reported that progression-free survival is significantly related to para-aortic lymph node metastasis. Computed tomography (CT) has been widely used for clinical staging, but its sensitivity for lymph nodal metastasis is low. Therefore, this prospective study was undertaken to evaluate (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) in detecting para-aortic lymph nodal metastasis in patients with locally advanced cervical carcinoma when CT findings were negative.
Fifty women with advanced cervical cancer confined to the pelvis with negative abdominal CT findings were included in this study. After 10 mCi of FDG was administered intravenously, the abdomens were scanned by PET. Para-aortic lymph node metastases were diagnosed as present or absent according to a standardized staging procedure.
Retroperitoneal surgical exploration revealed 14 patients with para-aortic lymph nodal metastasis. Two patients had false-negative FDG-PET findings and the other two patients had false-positive FDG-PET findings.
Overall, FDG-PET imaging had a sensitivity of 85.7%, a specificity of 94.4%, and an accuracy of 92%. When abdominal CT findings are negative, the use of FDG-PET can accurately detect para-aortic lymph nodal metastatis in patients with advanced cervical cancer.
据报道，在晚期宫颈癌中，无进展生存期与腹主动脉旁淋巴结转移显著相关。计算机断层扫描（CT）已广泛用于临床分期，但其对淋巴结转移的敏感性较低。因此，本前瞻性研究旨在评估当CT检查结果为阴性时，18F-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在检测局部晚期宫颈癌患者腹主动脉旁淋巴结转移中的作用。
本研究纳入了50例局限于盆腔的晚期宫颈癌患者，其腹部CT检查结果为阴性。静脉注射10 mCi的FDG后，对腹部进行PET扫描。根据标准化分期程序诊断腹主动脉旁淋巴结转移是否存在。
腹膜后手术探查发现14例患者存在腹主动脉旁淋巴结转移。2例患者FDG-PET检查结果为假阴性，另外2例患者FDG-PET检查结果为假阳性。
总体而言，FDG-PET成像的敏感性为85.7%，特异性为94.4%，准确性为92%。当腹部CT检查结果为阴性时，使用FDG-PET可以准确检测晚期宫颈癌患者的腹主动脉旁淋巴结转移。
