SUV 值在预测局部晚期宫颈癌患者盆腔淋巴结转移中的作用：一项整合 PET/CT 的研究。
The value of the SUV ratio between lymph node and bone marrow in predicting pelvic lymphatic metastasis of patients with locally advanced cervical cancer: an integrated PET/CT study.
机构信息
Department of Nuclear Medicine, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, People's Republic of China.
出版信息
Nucl Med Commun. 2022 Nov 1;43(11):1155-1160. doi: 10.1097/MNM.0000000000001613. Epub 2022 Aug 25.
PURPOSE
This study aimed to evaluate the value of the standardized uptake value (SUV) ratio between lymph nodes and bone marrow (BM) measured by Fluorine-18-fluorodeoxyglucose PET and computed tomography ( 18 F-FDG PET/CT) for predicting pelvic lymph node (PLN) metastasis in patients with locally advanced cervical cancer (LACC).
MATERIALS AND METHODS
A total of 62 patients with pathological stage Ib-IVa cervical cancer who underwent 18 F-FDG PET/CT before treatment were reviewed retrospectively. We measured the metabolic and morphological parameters of lymph nodes and primary tumors, bone marrow SUV (SUVBM) and calculated the ratio of lymph nodes maximum SUV (SUVmax) to bone marrow SUV (SUVLN/BM) and the ratio of short-axis diameter to long-axis diameter (Ds/l) of lymph nodes. A receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic efficacy of each parameter.
RESULTS
There were 180 lymph nodes with pathological evidence included in the study. Our results indicated that Ds/l, SUVmax of lymph nodes (SUVLN) and SUVLN/BM were independent risk factors for PLN metastasis in LACC ( P < 0.05), and SUVLN/BM showed the best diagnostic performance by ROC curve analysis. The SUVBM in the anemia group was significantly higher than that in the nonanemia group (3.05 vs. 2.40, P < 0.05); furthermore, false-positive cases decreased when the SUVLN/BM was used as the diagnostic criterion instead of SUVLN, especially in the anemia group. ROC curve analysis showed that the area under the curve value of the combination of SUVLN/BM and Ds/l was 0.884 ( P < 0.05), which was higher than Ds/l or SUVLN/BM alone.
CONCLUSIONS
SUVLN/BM could improve the ability to predicting PLN metastasis in patients with LACC, and the diagnostic efficacy of the combination of SUVLN/BM and Ds/l might be better than that of a single parameter.
目的
本研究旨在评估氟-18-氟代脱氧葡萄糖正电子发射断层扫描和计算机断层扫描（18 F-FDG PET/CT）测量的淋巴结与骨髓（BM）之间的标准化摄取值（SUV）比值在预测局部晚期宫颈癌（LACC）患者盆腔淋巴结（PLN）转移中的价值。
材料和方法
回顾性分析了 62 例接受治疗前 18 F-FDG PET/CT 检查的病理分期 Ib-IVa 期宫颈癌患者。我们测量了淋巴结和原发肿瘤的代谢和形态参数、骨髓 SUV（SUVBM），并计算了淋巴结最大 SUV（SUVmax）与骨髓 SUV（SUVLN/BM）的比值以及淋巴结短轴与长轴直径的比值（Ds/l）。通过绘制受试者工作特征（ROC）曲线评估各参数的诊断效能。
结果
本研究共纳入 180 个有病理证据的淋巴结。结果表明，Ds/l、淋巴结 SUVmax（SUVLN）和 SUVLN/BM 是 LACC 患者 PLN 转移的独立危险因素（P ＜0.05），ROC 曲线分析显示 SUVLN/BM 具有最佳的诊断性能。贫血组的 SUVBM 明显高于非贫血组（3.05 比 2.40，P ＜0.05）；此外，当使用 SUVLN/BM 作为诊断标准而不是 SUVLN 时，假阳性病例减少，特别是在贫血组。ROC 曲线分析显示，SUVLN/BM 与 Ds/l 联合的曲线下面积值为 0.884（P ＜0.05），高于 Ds/l 或 SUVLN/BM 单独使用时的值。
结论
SUVLN/BM 可提高预测 LACC 患者 PLN 转移的能力，SUVLN/BM 与 Ds/l 联合的诊断效能可能优于单一参数。
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