Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2012 Jan;23(1):28-34. doi: 10.3802/jgo.2012.23.1.28. Epub 2012 Jan 9.
To determine whether [(18)F]FDG uptake on PET/CT imaging before surgical staging has prognostic significance in patients with epithelial ovarian cancer (EOC).
Patients with EOC were imaged with integrated PET/CT before surgical staging. Hypermetabolic lesions were measured as the standardized uptake value (SUV) in primary and metastatic tumors. SUV distribution was divided into two regions at the level of umbilicus, and the impact of the ratio between above and below umbilicus (SUV(location) ratio) on progression-free survival (PFS) was examined using Cox proportional hazards regression.
Between January 2004 and December 2009, 55 patients with EOC underwent preoperative PET/CT. The median duration of PFS was 11 months (range, 3 to 43 months), and twenty (36.4%) patients experienced recurrence. In univariate analysis, high SUV(location) ratio (p=0.002; hazard ratio [HR], 1.974; 95% confidence interval [CI], 1.286 to 3.031) was significantly associated with recurrence. Malignant mixed mullerian tumor compared with endometrioid histology was also shown to have significance. In multivariate analysis, high SUV(location) ratio (p=0.005; HR, 2.418; 95% CI, 1.1315 to 4.447) and histology (serous, mucinous, and malignant mixed mullerian tumor compared with endometrioid type) were significantly associated with recurrence. Patients were categorized into two groups according to SUV(location) ratio (<0.3934 vs. ≥0.3934), and the Kaplan-Meier survival graph showed a significant difference in PFS between the groups (p=0.0021; HR, 9.47, log-rank test).
SUV distribution showed a significant association with recurrence in patients with EOC, and may be a useful predictor of recurrence.
确定上皮性卵巢癌（EOC）患者手术分期前 PET/CT 成像中[（18）F]FDG 摄取是否具有预后意义。
对 EOC 患者进行了集成 PET/CT 成像。将原发性和转移性肿瘤的标准摄取值（SUV）测量为代谢活跃的病变。将 SUV 分布在脐部水平分为两个区域，并使用 Cox 比例风险回归检查脐上和脐下区域（SUV（位置）比值）之间的比值对无进展生存期（PFS）的影响。
2004 年 1 月至 2009 年 12 月期间，55 例 EOC 患者接受了术前 PET/CT 检查。中位 PFS 为 11 个月（范围 3 至 43 个月），20 例（36.4%）患者出现复发。在单因素分析中，高 SUV（位置）比值（p=0.002；风险比 [HR]，1.974；95%置信区间 [CI]，1.286 至 3.031）与复发显著相关。恶性混合性苗勒管肿瘤与子宫内膜样组织学相比也具有显著意义。在多因素分析中，高 SUV（位置）比值（p=0.005；HR，2.418；95%CI，1.1315 至 4.447）和组织学（浆液性、黏液性和恶性混合性苗勒管肿瘤与子宫内膜样类型）与复发显著相关。根据 SUV（位置）比值（<0.3934 与≥0.3934）将患者分为两组，Kaplan-Meier 生存图显示两组之间在 PFS 上有显著差异（p=0.0021；HR，9.47，对数秩检验）。
EOC 患者的 SUV 分布与复发显著相关，可能是复发的有用预测指标。
