Bese Tugan, Bicer Elifnur, Tetikli Kosuk Asli, Akovali Burak, Turan Hasan, Kabasakal Levent, Demirkiran Fuat
Gynecologic Oncology Division, Obstetrics and Gynecology Department.
Obstetrics and Gynecology Department.
Nucl Med Commun. 2023 Mar 1;44(3):204-211. doi: 10.1097/MNM.0000000000001654. Epub 2022 Dec 16.
Our aim in this study was to determine the relationship between tumor mean standard uptake value (SUVmax) value in preoperative PET/computed tomography (CT) and prognostic risk groups in cases with endometrial cancer.
A total of 368 patients operated on for endometrial cancer were evaluated in the study. The SUVmax value of endometrial primary tumor of the patients screened within 30 days of operation, was compared with prognostic parameters and risk groups. P value <0.05 was considered significant for all tests.
A statistically significant relationship was found between the mean SUVmax value and risk groups ( P < 0.001), grade ( P < 0.001), stage ( P < 0.001), myometrial invasion of the tumor ( P < 0.001), cervical involvement ( P = 0.002), lymphovascular space invasion (LVSI) ( P < 0.001), lymph node metastasis ( P < 0.001), tumor size ( P < 0.001), lymph node involvement in PET/CT ( P < 0.001). There was no significant relationship found between the histologic type of tumor and the mean SUVmax value ( P = 0.113). Cutoff SUVmax value for endometrial cancer tumor tissue, which will be used to determine the possible lymph node metastasis, was accepted as 19 as a result of the ROC analysis. The risk of lymph node metastasis was found 4.74 times (confidence interval, 2.510-8.977) higher in patients with SUVmax value above cutoff 19 ( P < 0.001). Considering risk groups, it was observed that patients with mean SUVmax value above 19 were in intermediate-high and high risk group, 2.3 times more than those in low and intermediate risk group ( P < 0.001). As a result of logistic regression analysis, in determining intermediate-high and high-risk groups, histological type ( P < 0.001), myometrial invasion ( P = 0.003), cervical invasion (CI) ( P < 0.001), grade ( P = 0.018) and SUVmax value ( P = 0.028) had statistically significant importance.
The higher the mean SUVmax value in the endometrial cancer tumor tissue in preoperative PET/CT in patients with endometrial cancer, the higher the risk group of the patients.
本研究旨在确定子宫内膜癌患者术前正电子发射断层显像/计算机断层扫描（PET/CT）中肿瘤平均标准摄取值（SUVmax）与预后风险组之间的关系。
本研究共评估了368例行子宫内膜癌手术的患者。对在手术30天内筛查的患者子宫内膜原发性肿瘤的SUVmax值与预后参数和风险组进行比较。所有检验的P值<0.05被认为具有统计学意义。
发现平均SUVmax值与风险组（P<0.001）、分级（P<0.001）、分期（P<0.001）、肿瘤肌层浸润（P<0.001）、宫颈受累（P=0.002）、淋巴管间隙浸润（LVSI）（P<0.001）、淋巴结转移（P<0.001）、肿瘤大小（P<0.001）以及PET/CT中的淋巴结受累（P<0.001）之间存在统计学显著关系。未发现肿瘤组织学类型与平均SUVmax值之间存在显著关系（P=0.113）。经ROC分析，用于确定可能的淋巴结转移的子宫内膜癌肿瘤组织的SUVmax临界值被确定为19。SUVmax值高于临界值19的患者发生淋巴结转移的风险高4.74倍（置信区间，2.510 - 8.977）（P<0.001）。考虑风险组，观察到平均SUVmax值高于19的患者处于中高风险组和高风险组，比低风险组和中风险组多2.3倍（P<0.001）。逻辑回归分析结果显示，在确定中高风险组时，组织学类型（P<0.001）、肌层浸润（P=0.003）、宫颈浸润（CI）（P<0.001）、分级（P=0.018）和SUVmax值（P=0.028）具有统计学显著意义。
子宫内膜癌患者术前PET/CT中子宫内膜癌肿瘤组织的平均SUVmax值越高，患者的风险组越高。
