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一项评估MRI预测子宫内膜癌疾病范围准确性的前瞻性观察性研究。

A Prospective Observational Study Evaluating the Accuracy of MRI in Predicting the Extent of Disease in Endometrial Cancer.

作者信息

Goel Gaurav, Rajanbabu Anupama, Sandhya C J, Nair Indu R

机构信息

1Department of Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita University, Kochi, Kerala India.

2Department of Gynecologic Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita University, Kochi, Kerala India.

出版信息

Indian J Surg Oncol. 2019 Mar;10(1):220-224. doi: 10.1007/s13193-018-0832-9. Epub 2018 Dec 17.

DOI:10.1007/s13193-018-0832-9
PMID:30948904
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6414579/
Abstract

This prospective study looks into the accuracy of magnetic resonance imaging (MRI) in predicting the depth of MI, cervical invasion, lymph node metastasis, and extrauterine spread (EUS) of disease in endometrial cancer. Between June 2014 and December 2015, 58 patients with biopsy-proven endometrial cancer who underwent MRI prior to surgery were included in the study. MRI findings like myometrial invasion, extrauterine spread, lymph nodal metastasis, and cervical invasion were compared against the histopathology report. Sensitivity, specificity, PPV, NPV, and overall accuracy of MRI for myometrial depth assessment were 75.0%, 73.08%, 77.2%, 70.37%, and 74.14 respectively. Sensitivity, specificity, PPV, NPV, and overall accuracy of MRI in assessing lymph node spread were 88.64%, 66.67%, 95.12%, 44.44%, and 86.0% respectively. As for predicting extrauterine spread and cervical invasion, MRI showed poor sensitivity (37.5% and 50% respectively) and a high specificity (92% and 100% respectively). Our study shows that preoperative MRI has high sensitivity and specificity to predict myometrial invasion and lymph node involvement. But, it is not sensitive enough to predict cervical involvement or extrauterine spread.

摘要

这项前瞻性研究探讨了磁共振成像(MRI)在预测子宫内膜癌肌层浸润深度、宫颈侵犯、淋巴结转移及宫外扩散(EUS)方面的准确性。2014年6月至2015年12月期间,纳入了58例经活检证实为子宫内膜癌且在手术前行MRI检查的患者。将MRI检查结果如肌层浸润、宫外扩散、淋巴结转移及宫颈侵犯与组织病理学报告进行比较。MRI评估肌层深度的敏感性、特异性、阳性预测值、阴性预测值及总体准确性分别为75.0%、73.08%、77.2%、70.37%及74.14%。MRI评估淋巴结扩散的敏感性、特异性、阳性预测值、阴性预测值及总体准确性分别为88.64%、66.67%、95.12%、44.44%及86.0%。至于预测宫外扩散和宫颈侵犯,MRI的敏感性较差(分别为37.5%和50%),但特异性较高(分别为92%和100%)。我们的研究表明,术前MRI在预测肌层浸润和淋巴结受累方面具有较高的敏感性和特异性。但是,在预测宫颈受累或宫外扩散方面不够敏感。

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