Department of Obstetrics and Gynaecology, Bronovo Hospital, Bronovolaan 5, 2597 AX Den Haag, The Netherlands.
Cancer Imaging. 2013 Jul 22;13(3):314-22. doi: 10.1102/1470-7330.2013.0032.
Approximately 72% of endometrial cancers are FIGO stage I at diagnosis and about 10% have lymph node metastases. An ideal diagnostic test for nodal disease would be able to prevent both overtreatment (i.e. unnecessary lymphadenectomy) and undertreatment (i.e. withholding lymphadenectomy or adjuvant postoperative treatment to patients with lymph node metastases).
In this review we compare the accuracy of preoperative tests (computed tomography, magnetic resonance imaging, positron emission tomography-computed tomography, CA-125 serum levels, and ultrasonography) for the detection of lymph node metastases in endometrial cancers with the final histopathologic diagnosis after complete pelvic and para-aortic lymphadenectomy as the gold standard.
A systematic search in MEDLINE (using PubMed), Embase and The Cochrane Library was performed up to 23 July 2012.
We found one article that met our inclusion criteria for computed tomography, none for magnetic resonance imaging, 2 for positron emission tomography/computed tomography), 2 for CA-125 and none for ultrasonography.
Due to the lack of high-quality articles on a preoperative test for lymph node status in endometrial cancer, no proper comparison between these modalities can be made.
约 72%的子宫内膜癌在诊断时为 FIGO Ⅰ期，约 10%有淋巴结转移。一种理想的淋巴结疾病诊断试验应该能够防止过度治疗（即不必要的淋巴结切除术）和治疗不足（即对有淋巴结转移的患者不进行淋巴结切除术或术后辅助治疗）。
在本综述中，我们比较了术前检查（计算机断层扫描、磁共振成像、正电子发射断层扫描-计算机断层扫描、CA-125 血清水平和超声检查）在检测子宫内膜癌淋巴结转移方面的准确性，以完整的盆腔和腹主动脉旁淋巴结清扫术的最终组织病理学诊断为金标准。
系统检索了 MEDLINE（使用 PubMed）、Embase 和 The Cochrane Library，检索时间截至 2012 年 7 月 23 日。
我们发现一篇符合计算机断层扫描纳入标准的文章，没有一篇符合磁共振成像纳入标准的文章，有 2 篇符合正电子发射断层扫描-计算机断层扫描纳入标准的文章，有 2 篇符合 CA-125 纳入标准的文章，没有一篇符合超声检查纳入标准的文章。
由于缺乏子宫内膜癌淋巴结状态术前检查的高质量文章，因此无法对这些方法进行适当的比较。
