Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Medical Radiotechnology, Okayama University Graduate School of Health Sciences, Okayama, Japan.
Eur J Obstet Gynecol Reprod Biol. 2014 Feb;173:77-82. doi: 10.1016/j.ejogrb.2013.10.030. Epub 2013 Nov 5.
To investigate prognostic values of maximum standardized lymph node (LN) uptake (SUVmax), minimum apparent LN diffusion coefficient (ADCmin), and LN short-axis length in women with cervical cancer.
Retrospective review of diffusion-weighted magnetic resonance imaging (DWI) and positron emission tomography/computed tomography (PET/CT) of LN confined to the pelvis in 80 cervical cancer patients before undergoing radiotherapy (RT) with or without concurrent chemotherapy. Optimal cut-off values for disease-free survival (DFS) and overall survival (OS) were determined by receiver operating characteristic (ROC) curve analysis. We used ROC curve analyses to evaluate whether LN SUVmax, LN ADCmin and LN short-axis length predicted risk of recurrence or survival.
Median DFS and OS for all patients were 18.97 and 22.28 months, respectively. DFS and OS rates of patients with high LN SUVmax was significantly lower than those of patients exhibiting low LN SUVmax (P=0.003 and P=0.019). Patients with low LN ADCmin had poorer DFS and OS than those with high LN ADCmin (P=0.033 and P=0.005). DFS for patients exhibiting longer LN short-axis length was significantly lower than those of patients exhibiting shorter LN short-axis length (P=0.018). Multivariate analyses indicated that high LN SUVmax was an independent predictor for both DFS and OS (P=0.0231 and P=0.0146).
LN SUVmax could be an important predictor of recurrence and survival in patients with cervical cancer confined to the pelvis.
探讨最大标准化淋巴结摄取量（SUVmax）、最小表观淋巴结扩散系数（ADCmin）和淋巴结短轴长度对宫颈癌患者的预后价值。
回顾性分析 80 例宫颈癌患者盆腔淋巴结弥散加权磁共振成像（DWI）和正电子发射断层扫描/计算机断层扫描（PET/CT）资料，这些患者在接受放疗（RT）或放化疗前均行 DWI 和 PET/CT 检查。通过受试者工作特征（ROC）曲线分析确定无病生存（DFS）和总生存（OS）的最佳截断值。我们使用 ROC 曲线分析评估 LN SUVmax、LN ADCmin 和 LN 短轴长度是否预测复发或生存风险。
所有患者的中位 DFS 和 OS 分别为 18.97 和 22.28 个月。LN SUVmax 较高的患者的 DFS 和 OS 率明显低于 LN SUVmax 较低的患者（P=0.003 和 P=0.019）。LN ADCmin 较低的患者的 DFS 和 OS 明显低于 LN ADCmin 较高的患者（P=0.033 和 P=0.005）。LN 短轴长度较长的患者的 DFS 明显低于 LN 短轴长度较短的患者（P=0.018）。多因素分析表明，LN SUVmax 是 DFS 和 OS 的独立预测因素（P=0.0231 和 P=0.0146）。
LN SUVmax 可能是预测宫颈癌患者盆腔淋巴结转移复发和生存的重要指标。
