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, Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Eur J Nucl Med Mol Imaging. 2018 Jan;45(1):47-55. doi: 10.1007/s00259-017-3805-2. Epub 2017 Aug 21.
To determine whether the relative metabolic activity of pelvic or para-aortic LN compared with that of primary tumor measured by preoperative [F]FDG PET/CT scan has prognostic value in patients with endometrioid endometrial carcinoma.
We retrospectively reviewed patients with endometrioid endometrial carcinoma who underwent preoperative [F]FDG PET/CT scans. Prognostic values of PET/CT-derived metabolic variables such as maximum standardized uptake value (SUV) of the primary endometrial carcinoma (SUV) and LN (SUV), and the LN-to-endometrial carcinoma SUV ratio (SUV / SUV) were assessed.
Clinico-pathological data, imaging data, and treatment results were reviewed for 107 eligible patients. Median post-surgical follow-up was 23 months (range, 6-60), and 7 (6.5%) patients experienced recurrence. Regression analysis showed that SUV / SUV (P < 0.001), SUV (P = 0.003), International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.006), and tumor grade (P = 0.011) were risk factors of recurrence. Multivariate regression analysis revealed that FIGO stage (P = 0.034) was the independent risk factor of recurrence. SUV / SUV showed significant correlation with FIGO stage (P < 0.001), LN metastasis (P < 0.001), lymphovascular space invasion (P < 0.001), recurrence (P = 0.001), tumor grade (P < 0.001), and deep myometrial invasion of tumor (P = 0.022). Patient groups categorized by SUV / SUV showed significant difference in progression-free survival (Log-rank test, P = 0.001).
Preoperative SUV / SUV measured by [F]FDG PET/CT was significantly associated with recurrence, and may become a novel prognostic factor in patients with endometrioid endometrial carcinoma.
通过术前 [F]FDG PET/CT 扫描，确定与原发肿瘤相比，盆腔或腹主动脉旁淋巴结的相对代谢活性在子宫内膜样腺癌患者中是否具有预后价值。
我们回顾性分析了接受术前 [F]FDG PET/CT 扫描的子宫内膜样腺癌患者。评估了 PET/CT 衍生代谢变量的预后价值，如原发性子宫内膜癌（SUV）和淋巴结（SUV）的最大标准化摄取值（SUV），以及淋巴结与子宫内膜癌 SUV 比值（SUV/SUV）。
对 107 例符合条件的患者进行了临床病理数据、影像学数据和治疗结果的回顾性分析。中位术后随访时间为 23 个月（范围 6-60 个月），7 例（6.5%）患者复发。回归分析显示，SUV/SUV（P<0.001）、SUV（P=0.003）、国际妇产科联合会（FIGO）分期（P=0.006）和肿瘤分级（P=0.011）是复发的危险因素。多变量回归分析显示，FIGO 分期（P=0.034）是复发的独立危险因素。SUV/SUV 与 FIGO 分期（P<0.001）、淋巴结转移（P<0.001）、血管淋巴管间隙浸润（P<0.001）、复发（P=0.001）、肿瘤分级（P<0.001）和肿瘤深肌层浸润（P=0.022）显著相关。根据 SUV/SUV 分类的患者在无进展生存方面存在显著差异（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，可能成为子宫内膜样腺癌患者的一种新的预后因素。
