From the Department of Nuclear Medicine, University of Pretoria.
Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria.
Clin Nucl Med. 2021 May 1;46(5):375-381. doi: 10.1097/RLU.0000000000003549.
The aim of this study was to assess the impact of 18F-FDG PET/CT metabolic parameters obtained at initial staging of vulva carcinoma on survival in women with and without HIV infection.
18F-FDG PET/CT images of women with vulva cancer who are planned for definitive therapy were analyzed. SUVmax, SUVmean, MTV, and total lesion glycolysis (TLG) as well as whole-body MTV and whole-body TLG were computed.
Twenty-five women were included with a mean age of 43.44 ± 10.32. The majority of the patients were HIV infected with a median CD4 count of 444.00 cells/mm3. The HIV-infected women are younger at diagnosis than their HIV-uninfected counterparts. All patients presented with inguinofemoral lymph node involvement, whereas half the patients had pelvic nodal metastasis. All the patients with distant visceral or skeletal metastasis were HIV infected. The lungs were the most common site of distant metastasis. When comparing the SUVmax, SUVmean, MTV, TLG, wbMTV, and wbTLG between HIV-infected and HIV-uninfected patients, we did not find statistical differences. Twelve patients (48%) were upstaged to metastatic disease. Seven patients had died at the time of analysis. The wbMTV and wbTLG were significantly higher in nonsurvivors than survivors.
18F-FDG PET/CT improves initial staging of squamous cell carcinoma among women with and without HIV infection. The whole-body tumor burden assessed by 18F-FDG PET metabolic metrics did not differ between HIV-infected and HIV-uninfected women. A higher whole-burden tumor burden is associated with a higher risk of mortality among women with vulva cancer.
本研究旨在评估 18F-FDG PET/CT 代谢参数在评估有无 HIV 感染的女性外阴癌初始分期中的作用及其对生存的影响。
对计划行根治性治疗的外阴癌女性的 18F-FDG PET/CT 图像进行分析。计算最大标准摄取值(SUVmax)、平均标准摄取值(SUVmean)、肿瘤代谢体积(MTV)和总病灶糖酵解(TLG)以及全身 MTV 和全身 TLG。
共纳入 25 例女性患者，平均年龄为 43.44±10.32 岁。大多数患者为 HIV 感染者，中位 CD4 计数为 444.00 个细胞/mm3。与 HIV 阴性患者相比，HIV 感染患者的诊断年龄更轻。所有患者均有腹股沟-股部淋巴结受累，而半数患者有盆腔淋巴结转移。所有有远处内脏或骨骼转移的患者均为 HIV 感染。肺部是最常见的远处转移部位。比较 HIV 感染和未感染患者的 SUVmax、SUVmean、MTV、TLG、wbMTV 和 wbTLG，我们未发现统计学差异。12 例患者(48%)被升级为转移性疾病。7 例患者在分析时死亡。非幸存者的 wbMTV 和 wbTLG 显著高于幸存者。
18F-FDG PET/CT 提高了有和无 HIV 感染的女性外阴鳞癌的初始分期。18F-FDG PET 代谢指标评估的全身肿瘤负荷在 HIV 感染和未感染女性之间无差异。外阴癌患者的全身肿瘤负荷越高，死亡率越高。
