Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Eur J Nucl Med Mol Imaging. 2017 Oct;44(11):1862-1869. doi: 10.1007/s00259-017-3729-x. Epub 2017 May 23.
Using integrated PET/CT, we evaluated the prognostic value of [F]FDG uptake ratio between pelvic lymph node (LN) and primary tumor in invasive squamous cell carcinoma (SCCA) of the uterine cervix.
We retrospectively reviewed patients with International Federation of Gynecology and Obstetrics (FIGO) stages IB to IIA cervical SCCA who underwent preoperative [F]FDG PET/CT scans. PET/CT parameters such as maximum standardized uptake value (SUV) of the primary cervical cancer (SUV) and LN (SUV), and the LN-to-cervical cancer SUV ratio (SUV/SUV) were assessed. Prognostic values of PET/CT-derived metabolic and volumetric variables and clinicopathology parameters were analyzed to predict progression-free survival (PFS) in regression analyses.
Clinical data, treatment modalities, and results were reviewed for 103 eligible patients. Median post-surgical follow-up was 29 months (range, 6-89), and 19 (18.5%) patients experienced recurrence. Multivariate logistic regression analysis showed that SUV / SUV > 0.1747(P = 0.048) was the independent risk factor of recurrence. Patient group categorized by SUV/SUV showed significant difference in PFS (log-rank test, P < 0.001).
Preoperative SUV/SUV measured by [F]FDG PET/CT was significantly associated with recurrence, and has an incremental prognostic value for PFS in patients with cervical SCCA.
我们使用整合的 PET/CT，评估了宫颈浸润性鳞状细胞癌（SCCA）中盆腔淋巴结（LN）和原发肿瘤之间 [F]FDG 摄取比值的预后价值。
我们回顾性分析了 103 例接受术前 [F]FDG PET/CT 扫描的国际妇产科联合会（FIGO）分期为 IB 至 IIA 期的宫颈 SCCA 患者。评估了 PET/CT 参数，如原发宫颈癌的最大标准化摄取值（SUV）（SUV）和 LN（SUV），以及 LN 与宫颈癌 SUV 比值（SUV/SUV）。对 PET/CT 衍生的代谢和体积变量以及临床病理参数的预后价值进行分析，以回归分析预测无进展生存（PFS）。
回顾了 103 例合格患者的临床数据、治疗方式和结果。中位术后随访时间为 29 个月（范围 6-89 个月），19 例（18.5%）患者复发。多变量逻辑回归分析显示，SUV/SUV>0.1747（P=0.048）是复发的独立危险因素。根据 SUV/SUV 对患者进行分组，在 PFS 方面存在显著差异（对数秩检验，P<0.001）。
术前 [F]FDG PET/CT 测量的 SUV/SUV 与复发显著相关，对宫颈 SCCA 患者的 PFS 具有附加的预后价值。
