通过 CT 对高级别浆液性卵巢癌的形态学亚型进行特征分析：一项回顾性队列研究。
Characterizing morphologic subtypes of high-grade serous ovarian cancer by CT: a retrospective cohort study.
机构信息
Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Division of Gynecologic Oncology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.
出版信息
Int J Gynecol Cancer. 2023 Jun 5;33(6):937-943. doi: 10.1136/ijgc-2022-004206.
OBJECTIVE
A novel classification system of high-grade serous ovarian carcinoma based on gross morphology observed at pre-treatment laparoscopy was recently defined. The purpose of this study was to identify radiographic features unique to each morphologic subtype.
METHODS
This retrospective study included 109 patients with high-grade serous ovarian cancer who underwent pre-operative computed tomography (CT) scanning and laparoscopic assessment of disease burden between 1 April 2013 and 5 August 2015. Gross morphologic subtype had been previously assigned by laparoscopy. Two radiologists independently reviewed CT images for each patient, categorized disease at eight anatomic sites, and assessed for radiographic characteristics of interest: large infiltrative plaques, mass-like metastases, enhancing peritoneal lining, architectural distortion, fat stranding, calcifications, and lymph node involvement. Demographic and clinical information was summarized with descriptive statistics and compared using Student's t-tests, χ² tests, or Fisher exact tests as appropriate; kappa statistics were used to assess inter-reader agreement.
RESULTS
Certain radiographic features were found to be associated with gross morphologic subtype. Large infiltrative plaques were more common in type 1 disease (88.7% (47/53) vs 71.4% (25/35), p=0.04), while mass-like metastases were more often present in type 2 disease (48.6% (17/35) vs 22.6% (12/53), p=0.01). Additionally, radiographic presence of disease at the falciform ligament was more common in type 1 morphology (33.9% (19/56) vs 13.2% (5/38), p=0.02).
CONCLUSION
Morphologic subtypes of high-grade serous ovarian cancer were associated with specific CT findings, including the presence of large infiltrative plaques, mass-like metastases, and falciform ligament involvement.
目的
最近基于术前腹腔镜检查时观察到的大体形态定义了一种新型高级别浆液性卵巢癌分类系统。本研究的目的是确定每种形态亚型特有的放射学特征。
方法
这项回顾性研究纳入了 2013 年 4 月 1 日至 2015 年 8 月 5 日期间接受术前计算机断层扫描（CT）扫描和腹腔镜评估疾病负担的 109 名高级别浆液性卵巢癌患者。大体形态亚型先前通过腹腔镜检查确定。两名放射科医生独立评估每位患者的 CT 图像，对 8 个解剖部位的疾病进行分类，并评估感兴趣的放射学特征：大浸润性斑块、块状转移、增强的腹膜衬里、结构扭曲、脂肪条纹、钙化和淋巴结受累。使用描述性统计数据总结人口统计学和临床信息，并使用学生 t 检验、卡方检验或 Fisher 确切检验进行比较（视情况而定）；kappa 统计用于评估读者间的一致性。
结果
发现某些放射学特征与大体形态亚型相关。大浸润性斑块在 1 型疾病中更为常见（88.7%（47/53）比 71.4%（25/35），p=0.04），而块状转移在 2 型疾病中更为常见（48.6%（17/35）比 22.6%（12/53），p=0.01）。此外，镰状韧带处存在疾病的放射学表现更常见于 1 型形态（33.9%（19/56）比 13.2%（5/38），p=0.02）。
结论
高级别浆液性卵巢癌的形态亚型与特定的 CT 发现相关，包括大浸润性斑块、块状转移和镰状韧带受累的存在。
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