Song Changho, Lee Jong Jin, Lee Shin-Hwa, Park Jeong-Yeol, Kim Dae-Yeon, Suh Dae-Shik, Kim Jong-Hyeok, Kim Yong-Man, Kim Ju-Hyun
Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan.
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul.
Nucl Med Commun. 2023 Nov 1;44(11):1005-1010. doi: 10.1097/MNM.0000000000001741. Epub 2023 Aug 14.
High-grade neuroendocrine cervical cancer (HGNECC) is a rare and aggressive cervical cancer subtype. In this study, we aimed to evaluate the prognostic value of fluorodeoxyglucose-PET/computed tomography (CT) parameters for HGNECC.
This single-center retrospective study included 29 patients with HGNECC who underwent fluorodeoxyglucose-PET/CT scan followed by surgery between 2006 and 2016.
The median follow-up period was 40 (range, 4-184) months. After surgery, the resection margins were tumor-negative in 28 patients (96.6%), 8 (27.6%) patients had parametrial tumor invasion, and 7 patients (24.1%) tested positive for lymph node metastasis. The tumor recurred in 20 patients (69%) and 18 patients (62.1%) died during the observation period. In the univariate analyses, age and total lesion glycolysis (TLG) were associated with worse disease-free survival (DFS) (age, hazard ratio 1.056, 95% CI 1.014-1.100, P = 0.009; TLG2.5, hazard ratio 1.003, 95% CI 1-1.006, P = 0.033; and TLG3.0, hazard ratio 1.003, 95% CI 1-1.006, P = 0.034). In the multivariate analyses, older age and higher TLG3.0 were identified as independent poor prognostic factors for DFS (age, hazard ratio 1.058, 95% CI 1.014-1.104, P = 0.009; TLG3.0, hazard ratio 1.004, 95% CI 1-1.007, P = 0.033), while resection margin involvement was identified as an independent factor to predict poor overall survival (hazard ratio 20.717, 95% CI 1.289-332.964, P = 0.032).
Among the preoperative fluorodeoxyglucose-PET/CT parameters, TLG3.0 may be useful for predicting DFS in patients with HGNECC.
高级别神经内分泌宫颈癌（HGNECC）是一种罕见且侵袭性强的宫颈癌亚型。在本研究中，我们旨在评估氟脱氧葡萄糖-PET/计算机断层扫描（CT）参数对HGNECC的预后价值。
这项单中心回顾性研究纳入了29例HGNECC患者，这些患者在2006年至2016年间接受了氟脱氧葡萄糖-PET/CT扫描，随后接受了手术。
中位随访期为40（范围4-184）个月。手术后，28例患者（96.6%）的手术切缘无肿瘤，8例患者（27.6%）有宫旁组织肿瘤侵犯，7例患者（24.1%）淋巴结转移检测呈阳性。20例患者（69%）出现肿瘤复发，18例患者（62.1%）在观察期内死亡。在单因素分析中，年龄和总病变糖酵解（TLG）与无病生存期（DFS）较差相关（年龄，风险比1.056，95%可信区间1.014-1.100，P = 0.009；TLG2.5，风险比1.003，95%可信区间1-1.006，P = 0.033；TLG3.0，风险比1.003，95%可信区间1-1.006，P = 0.034）。在多因素分析中，年龄较大和TLG3.0较高被确定为DFS的独立不良预后因素（年龄，风险比1.058，95%可信区间1.014-1.104，P = 0.009；TLG3.0，风险比1.004，95%可信区间1-1.007，P = 0.033），而手术切缘受累被确定为预测总生存期较差的独立因素（风险比20.717，95%可信区间1.289-332.964，P = 0.032）。
在术前氟脱氧葡萄糖-PET/CT参数中，TLG3.0可能有助于预测HGNECC患者的DFS。
