Roh Hyun Jin, Kim Kyung Bin, Lee Jong Hwa, Kim Hwa Jung, Kwon Yong-Soon, Lee Sang Hun
Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Department of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
Int J Surg Oncol. 2018 Aug 1;2018:9120753. doi: 10.1155/2018/9120753. eCollection 2018.
We assess the predictive significance of preoperative 3-Tesla multiparametric MRI findings.
A total of 260 patients with FIGO IA2-IIA cervical cancer underwent primary surgical treatment between 2007 and 2016. Univariable and multivariable logistic regression analyses were used to assess the incremental prognostic significance.
The clinical predictive factors associated with pT2b disease were MRI parametrial invasion (PMI) (adjusted odds ratio (AOR) 3.77, 95% confidence interval(CI) 1.62-8.79; P=0.02) and MRI uterine corpus invasion (UCI) (AOR 9.99, 95% CI 4.11-24.32; P<0.0001). In multivariable analysis, for underdiagnoses, histologically squamous carcinoma versus adenocarcinoma and adenosquamous carcinoma (AOR 2.07, 95% CI 1.06-4.07; P=0.034) and MRI tumor size (AOR 0.76, 95% CI 0.63-0.92; P=0.005) were significant predictors; for overdiagnoses, these results were MRI tumor size (AOR 1.51, 95% CI 1.06-2.16; P=0.023), MRI PMI (AOR 71.73, 95% CI 8.89-611.38; P<0.0001) and MRI UCI (AOR 0.19, 95% CI 0.01-1.01; P=0.051).
PMI and UCI on T2-weighted images through preoperative 3T MRI are useful coefficients for accurate prediction of the pT2b stage; however, careful surveillance is required. Therefore, preoperative decision-making for early cervical cancer patients based on MRI diagnosis should be considered carefully, particularly in the presence of factors that are known to increase the likelihood of misdiagnosis.
我们评估术前3特斯拉多参数磁共振成像（MRI）结果的预测意义。
2007年至2016年间，共有260例国际妇产科联盟（FIGO）IA2-IIA期宫颈癌患者接受了初次手术治疗。采用单变量和多变量逻辑回归分析来评估增量预后意义。
与pT2b疾病相关的临床预测因素为MRI宫旁浸润（PMI）（调整优势比[AOR]3.77，95%置信区间[CI]1.62-8.79；P=0.02）和MRI子宫体浸润（UCI）（AOR 9.99，95%CI 4.11-24.32；P<0.0001）。在多变量分析中，对于漏诊，组织学类型为鳞状细胞癌与腺癌及腺鳞癌相比（AOR 2.07，95%CI 1.06-4.07；P=0.034）以及MRI肿瘤大小（AOR 0.76，95%CI 0.63-0.92；P=0.005）是显著预测因素；对于误诊，这些结果为MRI肿瘤大小（AOR 1.51，95%CI 1.06-2.16；P=0.023）、MRI PMI（AOR 71.73，95%CI 8.89-611.38；P<0.0001）和MRI UCI（AOR 0.19，95%CI 0.01-1.01；P=0.051）。
通过术前3T MRI的T2加权图像上的PMI和UCI是准确预测pT2b期的有用系数；然而，需要仔细监测。因此，对于早期宫颈癌患者，基于MRI诊断的术前决策应谨慎考虑，尤其是在存在已知增加误诊可能性的因素时。
