MRI在子宫内膜癌局部分期中检测≥pT1b期疾病的性能。

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer.

作者信息

Van Vynckt Leonie, Tummers Philippe, Denys Hannelore, Göker Menekse, Hendrickx Sigi, Naert Eline, Salihi Rawand, Van de Vijver Koen, van Ramshorst Gabriëlle H, Van Weehaeghe Donatienne, Vandecasteele Katrien, Villeirs Geert M, De Visschere Pieter J L

机构信息

Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium.

Department of Obstetrics and Gynecology, Ghent University Hospital, 9000 Ghent, Belgium.

出版信息

Cancers (Basel). 2024 Mar 13;16(6):1142. doi: 10.3390/cancers16061142.

DOI:10.3390/cancers16061142

PMID:38539477

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10968934/

Abstract

Magnetic resonance imaging (MRI) can be used for the preoperative local staging of endometrial cancer (EC). The presence of ≥pT1b disease (i.e., tumor invasion in ≥50% of the myometrium, into the cervical stroma or spread outside the uterus) has important prognostic value and implications for the decision to perform lymphadenectomy. The purpose of this study was to assess the performance of MRI for the detection of ≥pT1b disease and to evaluate whether tumor size measured via MRI was predictive for ≥pT1b disease, independent of imaging signs of deep invasion. MRI T-staging and tumor diameter and volume were correlated with histopathology of the hysterectomy specimen in 126 patients. MRI had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 70.0%, 83.3%, 79.2%, 75.3% and 77.0%, respectively, for the detection of ≥pT1b disease. A tumor diameter of ≥40 mm and volume of ≥20 mL measured via MRI were predictive for ≥pT1b disease at rates of 78.3% and 87.1%, respectively. An EC size of at least 5 mm upon MRI was predictive for ≥pT1b disease in more than 50% of cases. Our results support the use of MRI in the preoperative staging of EC and suggest including size criteria in EC staging guidelines.

摘要

磁共振成像（MRI）可用于子宫内膜癌（EC）的术前局部分期。≥pT1b期疾病（即肿瘤侵犯子宫肌层≥50%、侵犯宫颈间质或子宫外播散）的存在具有重要的预后价值，并对是否进行淋巴结清扫术的决策有影响。本研究的目的是评估MRI检测≥pT1b期疾病的性能，并评估通过MRI测量的肿瘤大小是否可独立于深层浸润的影像学征象预测≥pT1b期疾病。对126例患者的MRI T分期、肿瘤直径和体积与子宫切除标本的组织病理学进行了相关性分析。MRI检测≥pT1b期疾病的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为70.0%、83.3%、79.2%、75.3%和77.0%。通过MRI测量，肿瘤直径≥40 mm和体积≥20 mL对≥pT1b期疾病的预测率分别为78.3%和87.1%。MRI显示EC大小至少为5 mm时，在超过50%的病例中可预测≥pT1b期疾病。我们的结果支持在EC术前分期中使用MRI，并建议在EC分期指南中纳入大小标准。