Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai 201508, China; Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou 310009, China.
Department of radiology, Shanghai First Maternity and Infant Hospital, Tongji University, 536 ChangleRoad, Shanghai 200092, China.
Magn Reson Imaging. 2024 Oct;112:10-17. doi: 10.1016/j.mri.2024.06.002. Epub 2024 Jun 6.
To compare and explore the characteristics of squamous cell carcinoma (SCC), adenocarcinoma (AC) and adenosquamous carcinoma (ASC), usual-type endocervical adenocarcinoma (UEA) and gastric adenocarcinoma (GAC) of cervix.
A total of 728 cervical cancers (254 cases of AC, 252 cases of ASC, and 222 cases of SCC) confirmed by histopathology were retrospectively reviewed. Among AC, 119 UEA and 47 GAC were included. Clinical baseline data and tumor morphological features on MRI (including tumor location, shape, diameter and volume, margin, growth pattern, presence of fluid component or cyst, heterogenous and peritumoral enhancement) of all cases were collected and analyzed. The signal intensity (SI) of tumor and gluteus maximus muscle were measured and their ratios (SIR) were calculated based on T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and contrast-enhanced T1WI at arterial and delay phases (A/DCE-T1WI). These clinical and MRI features were compared between SCC, AC and ASC, UEA and GAC, and the specific ones of each subtype were identified.
There was a significant difference in SCC-Ag, CA-199, CEA, ADC value, SIR-DWI, presence of intratumor cyst and peritumoral enhancement between AC and ASC; in patient age, menopausal status, International Federation of Gynecology and Obstetrics (FIGO) stage, SCC-Ag, CA-125, CA-199, CEA, tumor shape, growth pattern, margin, presence of intratumor fluid component and cyst, tumor diameter and volume, ADC value, SIR-T1WI, SIR-T2WI, and SIR-DWI between SCC and AC, as well as SCC and ASC. Also, there was a significant difference in deep stromal invasion (DSI), peritumoral and heterogenous enhancement between SCC and AC, and in SIR-ACE-T1WI between SCC and ASC. There was a significant difference in reproductive history, menopausal status, FIGO stage, CA-199, DSI, lymph node metastasis (LNM), parametrial invasion (PMI), tumor location, shape, margin, growth pattern, presence of fluid component and cyst, tumor diameter and volume, SIR-T1WI, SIR-DWI, and heterogenous enhancement between GAC and UEA.
The clinical and MRI features with significant differences among SCC, AC and ASC, and between UEA and GAC, can help to identify each subtype of cervical cancer.
比较并探讨宫颈鳞癌（SCC）、腺癌（AC）和腺鳞癌（ASC）、普通型宫颈内膜腺癌（UEA）和胃型腺癌（GAC）的特征。
回顾性分析经组织病理学证实的 728 例宫颈癌（AC 254 例，ASC 252 例，SCC 222 例）。AC 中包括 119 例 UEA 和 47 例 GAC。收集并分析所有病例的临床基线数据和 MRI 肿瘤形态特征（包括肿瘤位置、形状、直径和体积、边界、生长方式、是否存在液性成分或囊肿、肿瘤内部和周围强化的异质性）。基于 T1 加权成像（T1WI）、T2 加权成像（T2WI）、弥散加权成像（DWI）、表观弥散系数（ADC）和动脉期和延迟期增强 T1WI（A/DCE-T1WI）测量肿瘤和臀大肌的信号强度（SI），并计算其比值（SIR）。比较 SCC、AC 和 ASC、UEA 和 GAC 之间的这些临床和 MRI 特征，并确定每种亚型的具体特征。
AC 和 ASC 之间 SCC-Ag、CA-199、CEA、ADC 值、SIR-DWI、肿瘤内囊肿和肿瘤周围强化存在显著差异；SCC 和 AC 之间患者年龄、绝经状态、国际妇产科联合会（FIGO）分期、SCC-Ag、CA-125、CA-199、CEA、肿瘤形状、生长方式、边界、肿瘤内液性成分和囊肿、肿瘤直径和体积、ADC 值、SIR-T1WI、SIR-T2WI 和 SIR-DWI 存在显著差异，SCC 和 ASC 之间也是如此。此外，SCC 和 AC 之间的深层间质浸润（DSI）、肿瘤周围和不均匀强化，以及 SCC 和 ASC 之间的 SIR-ACE-T1WI 存在显著差异。GAC 和 UEA 之间在生育史、绝经状态、FIGO 分期、CA-199、DSI、淋巴结转移（LNM）、宫旁浸润（PMI）、肿瘤位置、形状、边界、生长方式、是否存在液性成分和囊肿、肿瘤直径和体积、SIR-T1WI、SIR-DWI、不均匀强化方面存在显著差异。
SCC、AC 和 ASC 之间以及 UEA 和 GAC 之间具有显著差异的临床和 MRI 特征有助于识别宫颈癌的每种亚型。
