Ololade Kehinde, Mokgoro Neo P, Lawal Ismaheel O, Vorster Mariza, Boshomane Tebatso G, Sathekge Mike M
Department of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.
Hell J Nucl Med. 2017 Sep-Dec;20 Suppl:71-79.
HIV-positive women with cervical cancer have higher recurrence and death rates with shorter time to recurrence and death compared with HIV-negative subjects. The objective of this study was to compare the recurrence patterns in HIV-positive women with invasive cervical cancer to their HIV-negative counterparts using F-FDG PET/CT.
We evaluated 40 HIV- seropositive and 79 HIV-seronegative patients with recurrent cervical carcinoma using F-FDG PET/CT. The PET/CT datasets were interpreted by two independent readers blinded to the HIV status of the patients. Areas of disagreement were resolved by consensus. Cervical cancer recurrence was confirmed by biopsy and histological examination of tissue, correlation with conventional imaging (CT and MRI) and by follow-up F-FDG PET/CT.
HIV-positive patients were 9 years younger than the HIV-negative patients at the time of diagnosis; mean age 39 years versus 48 years respectively. Initial treatment was comparable in both groups. Time to recurrence was shorter in HIV-infected compared with HIV-uninfected women (11 versus 24 months). The commonest sites of metastatic recurrence was in the lymph nodes. HIV-infected patients demonstrated significant higher recurrence in lymph nodes and lungs (P<0.05). No significant difference in the recurrence rate in liver or bone (P>0.05) between both groups. HIV-infected patients showed unusual metastases to brain, spleen and skin.
By using the F-FDG PET/CT scan we showed that the time to recurrence is shorter among HIV seropositive patients with the commonest site of metastatic recurrence being in the lymph nodes. Nodal and liver metastases are significantly higher in HIV seropositive patients compared with seronegative patients.
与HIV阴性患者相比，感染HIV的宫颈癌女性复发率和死亡率更高，复发和死亡时间更短。本研究的目的是使用F-FDG PET/CT比较HIV阳性浸润性宫颈癌女性与HIV阴性女性的复发模式。
我们使用F-FDG PET/CT评估了40例HIV血清学阳性和79例HIV血清学阴性的复发性宫颈癌患者。PET/CT数据集由两名对患者HIV状态不知情的独立阅片者解读。分歧区域通过共识解决。宫颈癌复发通过组织活检和组织学检查、与传统影像学（CT和MRI）的相关性以及随访F-FDG PET/CT来确认。
HIV阳性患者在诊断时比HIV阴性患者年轻9岁；平均年龄分别为39岁和48岁。两组的初始治疗相当。与未感染HIV的女性相比，感染HIV的女性复发时间更短（11个月对24个月）。转移复发最常见的部位是淋巴结。感染HIV的患者在淋巴结和肺部的复发明显更高（P<0.05）。两组在肝脏或骨骼的复发率无显著差异（P>0.05）。感染HIV的患者出现了不寻常的脑、脾和皮肤转移。
通过使用F-FDG PET/CT扫描，我们发现HIV血清学阳性患者的复发时间更短，转移复发最常见的部位是淋巴结。与血清学阴性患者相比，HIV血清学阳性患者的淋巴结和肝脏转移明显更高。
