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MTV-s 作为 18F-FDG PET/CT 指标对 IIB-IVA 期宫颈癌患者的预测复发价值。

The predictive recurrence value of MTV-s as an 18F-FDG PET/CT index in patients with IIB-IVA cervical cancer.

机构信息

Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.

Department of Obstetrics and Gynecology, Shenyang Women's and Children's Hospital, Shenyang, Liaoning, China.

出版信息

Postgrad Med. 2021 May;133(4):436-443. doi: 10.1080/00325481.2021.1894823. Epub 2021 Mar 15.

Abstract

: The aim of this study was to explore the predictive recurrence value of the PET/CT index and some clinical features in patients with IIB-IVA cervical cancer.: This was a retrospective analysis of 84 patients with cervical cancer who underwent 18 F-FDG PET/CT scans before treatment. MTV-s is the sum of the metabolic volume of the primary cervical lesion (MTV-C) and the metabolic volume of the pelvic and abdominal paravascular metastatic lymph nodes (MTV-LN). We analyzed the relationships between clinical characteristics (age, FIGO stage, pathological pattern, degree of differentiation, tumor size, presence of LN metastasis), PET/CT index (SUVmax-C, SUVmax-LN, MTV-C, MTV-LN, MTV-s), and recurrence of cervical cancer using the chi-square test; the ROC curve was used to determine the PET/CT boundary parameters; and the COX proportional risk model was used for univariate and multivariate analysis of clinical features and the PET/CT index. The survival curve was drawn using the Kaplan-Meier method, comparing different groups by the log-rank test.: Eighty-four patients were included. During the observation period, 26 patients had tumor recurrence (31.0%). Univariate analysis showed that lymph node metastasis, lymph node SUVmax (SUVmax-LN), MTV-C, MTV-LN, and MTV-s were associated with PFS. MTV-s > 27.36 cm was an independent risk factor for PFS ( = 0.037). There were 41 patients with MTV-s > 27.36 cm, and 19 of them had tumor recurrence (46.3%). There were 43 patients with MTV-s ≤ 27.36 cm, 7 of whom had tumor recurrence (16.3%).: MTV-s can predict recurrence in patients with stage IIB-IVA cervical cancer, with a critical value of 27.36 cm. PET/CT can help clinicians judge the prognosis of patients more comprehensively.

摘要

目的

本研究旨在探讨 PET/CT 指标及部分临床特征对 IIB-IVA 期宫颈癌患者的预测复发价值。

方法

回顾性分析 84 例行 18F-FDG PET/CT 检查的宫颈癌患者资料。MTV-s 为原发宫颈病灶代谢体积(MTV-C)和盆腔及腹主动脉旁转移性淋巴结代谢体积(MTV-LN)的总和。采用卡方检验分析年龄、FIGO 分期、病理类型、分化程度、肿瘤大小、淋巴结转移等临床特征,以及 SUVmax-C、SUVmax-LN、MTV-C、MTV-LN、MTV-s 等 PET/CT 指标与宫颈癌复发的关系;采用 ROC 曲线确定 PET/CT 边界参数;采用 COX 比例风险模型进行单因素和多因素分析。采用 Kaplan-Meier 法绘制生存曲线,采用对数秩检验比较不同组间的差异。

结果

共纳入 84 例患者,观察期间 26 例患者肿瘤复发(31.0%)。单因素分析显示,淋巴结转移、淋巴结 SUVmax(SUVmax-LN)、MTV-C、MTV-LN、MTV-s 与 PFS 相关。MTV-s>27.36 cm 是 PFS 的独立危险因素( =0.037)。其中 MTV-s>27.36 cm 者 41 例,19 例肿瘤复发(46.3%);MTV-s≤27.36 cm 者 43 例,7 例肿瘤复发(16.3%)。

结论

MTV-s 可预测 IIB-IVA 期宫颈癌患者的复发情况,临界值为 27.36 cm。PET/CT 可帮助临床医生更全面地判断患者的预后。

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