[2009年国际妇产科联盟（FIGO）分期系统对子宫内膜癌术前MRI分期诊断价值的影响]
[Impact of 2009 FIGO staging system on the diagnostic value of preoperative MRI staging of endometrial carcinoma].
作者信息
Yu Xiao-duo, Ouyang Han, Lin Meng, Zhou Chun-wu, Zhang Rong
机构信息
Department of Imaging Diagnosis, Chinese Academy of Medical Sciences, Beijing, China.
出版信息
Zhonghua Zhong Liu Za Zhi. 2011 Sep;33(9):692-6.
OBJECTIVE
To analyze the changes of 2009 FIGO staging system compared with the 1988 FIGO staging system of endometrial carcinoma and evaluate the diagnostic value of MRI staging by the 2009 FIGO criteria.
METHODS
A retrospective study was performed on 63 consecutive patients with pathologically confirmed endometrial carcinoma who were treated by surgery initially from January to December 2009. The diagnostic value of preoperative MRI by the 2009 FIGO staging system was compared with that using the 1988 FIGO system, respectively.
RESULTS
According to the 2009 FIGO staging system of endometrial carcinoma, stage Ia was defined as no or less than half myometrial invasion, which included stage Ia (confined to endometrium) and stage Ib (invasion less than half of the myometrium) of the 1988 FIGO staging system. Stage Ib assessed by the 2009 FIGO system was the same as the stage Ic of 1988 FIGO system, indicating the lesions more than half myometrial invasion. Endocervical glandular involvement only (stage IIa of 1988 FIGO system) was classified as stage I. Positive cytology of ascites (stage IIIa of 1988 FIGO system) was excluded by the 2009 FIGO criteria. Using the 1988 FIGO system, the accuracy of MRI for the evaluation of endometrial carcinoma of stage Ia, Ib, Ic, whole stage I, IIa, IIb, whole stage II, IIIa, IIIb, IIIc, whole stage III and IVb were 95.2%, 79.4%, 81.0%, 84.1%, 96.8%, 90.5%, 90.5%, 92.1%, 98.4%, 92.1%, 82.5%, and 98.4%, respectively, while using the 2009 FIGO system, the accuracy of MRI of stage Ia, Ib, whole stage I, II, IIIa, IIIb, IIIc, whole stage III and IVb were 88.9%, 81.0%, 88.9%, 92.1%, 98.4%, 98.4%, 92.1%, 88.9% and 98.4%, respectively.
CONCLUSIONS
The 2009 FIGO staging system is simplified on the basis of the 1988 FIGO system. It gives an improved accuracy of MRI in evaluating the stage I to III endometrial carcinoma.
目的
分析2009年国际妇产科联盟（FIGO）子宫内膜癌分期系统与1988年FIGO分期系统相比的变化，并依据2009年FIGO标准评估MRI分期的诊断价值。
方法
对2009年1月至12月期间最初接受手术治疗的63例经病理确诊的子宫内膜癌患者进行回顾性研究。分别比较2009年FIGO分期系统和1988年FIGO系统术前MRI的诊断价值。
结果
依据2009年FIGO子宫内膜癌分期系统，Ia期定义为无肌层浸润或肌层浸润少于一半，这包括1988年FIGO分期系统中的Ia期（局限于子宫内膜）和Ib期（肌层浸润少于一半）。2009年FIGO系统评估的Ib期与1988年FIGO系统的Ic期相同，表明病变肌层浸润超过一半。仅宫颈腺体受累（1988年FIGO系统的IIa期）被归类为I期。2009年FIGO标准排除了腹水细胞学阳性（1988年FIGO系统的IIIa期）。使用1988年FIGO系统时，MRI对Ia期、Ib期、Ic期、I期整体、IIa期、IIb期、II期整体、IIIa期、IIIb期、IIIc期、III期整体及IVb期子宫内膜癌评估的准确率分别为95.2%、79.4%、81.0%、84.1%、96.8%、90.5%、90.5%、92.1%、98.4%、92.1%、82.5%和98.4%，而使用2009年FIGO系统时，MRI对Ia期、Ib期、I期整体、II期、IIIa期、IIIb期、IIIc期、III期整体及IVb期的准确率分别为88.9%、81.0%、88.9%、92.1%、98.4%、98.4%、92.1%、88.9%和98.4%。
结论
2009年FIGO分期系统在1988年FIGO系统的基础上进行了简化。它提高了MRI评估I至III期子宫内膜癌的准确性。
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