沙特阿拉伯临床与放射学相关性宫颈癌分期。
Cervical Cancer Staging in Saudi Arabia Clinicoradiological Correlation.
机构信息
Gynecology Oncology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
出版信息
Biomed Res Int. 2019 Jun 23;2019:8745828. doi: 10.1155/2019/8745828. eCollection 2019.
OBJECTIVE
The aim of this study was to compare the finding of pelvic MRI with clinical staging using cystoscopy and sigmoidoscopy for cervical cancer patients.
METHOD
We reviewed all patients with cervical cancer between January 2001 and December 2015. We correlate the clinical examination, cystoscopy, and sigmoidoscopy with MRI findings.
RESULT
A total of 152 patients were enrolled. 114 (74.9%) were with locally advanced cervix cancer. The true positives for MRI in the detection of parametrium were in 94 patients, with sensitivity, specificity, positive, PPV, and NPV of 72%, 82%, 96%, and 33%, respectively. The false negative of the MRI to detect the bladder invasion was 2. Nineteen patients reported having bladder invasion on MRI not confirmed by cystoscopy. None of the patients who had a negative rectal invasion by MRI were found to have rectal involvement by sigmoidoscopy with a specificity of 91%.
CONCLUSION
The combined MRI and clinical staging for parametrial evaluation should still be carried out for the staging of cervical cancer. However, in the absence of the bladder and the rectal invasion in the MRI, it will be safe to avoid the need for a cystoscopy and/or sigmoidoscopy for complete staging in the majority of patients with cervical cancer.
目的
本研究旨在比较经阴道 MRI 与膀胱镜和乙状结肠镜检查在宫颈癌患者临床分期中的发现。
方法
我们回顾了 2001 年 1 月至 2015 年 12 月期间所有宫颈癌患者的资料。我们将临床检查、膀胱镜和乙状结肠镜检查与 MRI 结果进行了比较。
结果
共纳入 152 例患者。114 例（74.9%）为局部晚期宫颈癌。MRI 检测宫旁组织的真阳性率为 94 例，其敏感性、特异性、阳性预测值、阴性预测值分别为 72%、82%、96%和 33%。MRI 对膀胱侵犯的假阴性率为 2.19%。19 例患者 MRI 报告有膀胱侵犯，但膀胱镜检查未证实。没有一例 MRI 直肠无侵犯而乙状结肠镜检查发现直肠受累的患者，特异性为 91%。
结论
对于宫颈癌的分期，应联合使用 MRI 和临床分期进行宫旁评估。但是，在 MRI 没有膀胱和直肠侵犯的情况下，对于大多数宫颈癌患者，避免膀胱镜和/或乙状结肠镜检查进行全面分期是安全的。
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