Department of Obstetrics and Gynecology, University of Freiburg, Medical School, Hugstetter Str 55, 79106 Freiburg, Germany.
Anticancer Res. 2010 Sep;30(9):3787-90.
In order to decrease surgery-related morbidity, we evaluated the reliability of the evaluation of lymph node metastasis in patients with uterine corpus cancer by positron-emission tomography (PET) with 2-[(18)F]fluoro-2-deoxy-D-glucose (FDG) before surgical staging.
Patients with newly diagnosed uterine corpus cancer scheduled for surgical staging, including lymphadenectomy, underwent PET imaging within 30 days before surgery. PET results and postoperative histopathology were compared for each patient and each nodal site. Sensitivity, specificity, positive and negative predictive value (PPV/NPV) as well as accuracy of FDG-PET in predicting nodal disease was determined by joined meta-analysis of the present data and the data available in the literature.
Of 21 patients examined, 13 patients were eligible to enter this pilot study. Only one patient had lymph node metastasis, which was preoperatively detected by FDG-PET scan. Additionally, another patient was considered to have lymph node metastasis according to increased focal FDG uptake; however, all lymph nodes were free of malignant disease upon final pathology. In contrast, all other patients without lymph node metastasis upon final pathology showed negative preoperative FDG-PET scans. The meta-analysis yielded a sensitivity, specificity, PPV, NPV and accuracy of 0.53, 0.91, 0.57, 0.90 and 0.84, respectively.
In patients with uterine corpus cancer, FDG-PET had an insufficient positive predictive value in detecting lymph node metastases, indicating that this method cannot replace surgical staging. However, due to its high NPV, FDG-PET might be beneficial in selected patients who are poor candidates for surgical staging.
为了降低与手术相关的发病率，我们评估了正电子发射断层扫描（PET）用 2-[(18)F]氟-2-脱氧-D-葡萄糖（FDG）对子宫体癌患者手术分期前淋巴结转移的评估可靠性。
计划进行手术分期（包括淋巴结切除术）的新诊断为子宫体癌的患者，在手术前 30 天内进行 PET 成像。对每位患者和每个淋巴结部位的 PET 结果和术后组织病理学进行了比较。通过对本研究数据和文献中可用数据的联合荟萃分析，确定 FDG-PET 预测淋巴结疾病的敏感性、特异性、阳性预测值（PPV/NPV）和阴性预测值（NPV）以及准确性。
在 21 名接受检查的患者中，有 13 名患者符合本研究的纳入标准。仅 1 名患者术前通过 FDG-PET 扫描检测到淋巴结转移。此外，另一名患者根据局部 FDG 摄取增加被认为有淋巴结转移；然而，所有淋巴结在最终病理检查中均未发现恶性疾病。相比之下，所有其他最终病理检查无淋巴结转移的患者术前 FDG-PET 扫描均为阴性。荟萃分析得出的敏感性、特异性、PPV、NPV 和准确性分别为 0.53、0.91、0.57、0.90 和 0.84。
在子宫体癌患者中，FDG-PET 在检测淋巴结转移方面的阳性预测值不足，表明该方法不能替代手术分期。然而，由于其高 NPV，FDG-PET 可能对不适合手术分期的患者有益。
