Malenković Goran, Malenković Jelena, Tomić Sanja, Šljivo Armin, Tomić Slobodan
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
ASA Institute for Research and Development and Innovation, 71 000 Sarajevo, Bosnia and Herzegovina.
J Clin Med. 2024 Dec 6;13(23):7445. doi: 10.3390/jcm13237445.
: This study primarily aims to evaluate the preoperative staging effectiveness of PET-CT in early-stage cervical cancer, particularly, its ability to detect primary tumors and micrometastases. : In this retrospective study, cervical cancer patients who had undergone preoperative 18F FDG PET-CT scans and were treated at the Department of Gynecology, Institute of Oncology, Vojvodina, in Sremska Kamenica, during the period from 2016 to 2020 were analyzed. : The study included 62 patients (mean age, 49.3 ± 9.6 years). Squamous cell carcinoma was the predominant histological type (95.2%), with G2 differentiation (82.3%) and FIGO stage Ib1 (80.6%) being the most common. Assessed by 18F FDG PET-CT, the mean tumor size was 26.4 ± 10.8 mm, which is slightly lower than the 26.9 mm measured during clinical examination ( = 0.784), with a significant (r = 0.678, < 0.001) correlation between these methods. 18F FDG PET-CT demonstrated an overall accuracy of 88.7% for identifying primary tumors, with a sensitivity of 86.8%, specificity of 100.0%, PPV of 100.0%, and NPV of 56.2%. An intraoperative examination showed identical overall accuracy but higher sensitivity (98.1%) and lower specificity (33.3%). For 18F FDG PET-CT, the level of agreement with the histopathological examination was good (Kappa 0.656), while for the intraoperative examination, it was moderate (Kappa 0.409). Regarding the lymph node assessment, 18F FDG PET-CT's accuracy was 82.2%, with a sensitivity of 53.8% and a specificity of 89.8%. The intraoperative examination showed lower accuracy (66.1%) but higher sensitivity (76.9%). The 18F FDG PET-CT Kappa value indicated moderate agreement (0.449), while the intraoperative examination showed poor agreement (0.282). : In conclusion, significant effectiveness is shown by 18F FDG PET-CT for preoperative staging of early-stage cervical cancer, offering superior accuracy in detecting primary tumors and micrometastases, particularly in predicting lymph node metastases, thereby enhancing diagnostic accuracy and informing treatment decisions.
本研究主要旨在评估PET-CT在早期宫颈癌术前分期中的有效性，尤其是其检测原发性肿瘤和微转移的能力。
在这项回顾性研究中，分析了2016年至2020年期间在斯雷姆斯卡卡梅尼察的伏伊伏丁那肿瘤研究所妇科接受术前18F FDG PET-CT扫描并接受治疗的宫颈癌患者。
该研究纳入了62例患者（平均年龄49.3±9.6岁）。鳞状细胞癌是主要的组织学类型（95.2%），最常见的是G2分化（82.3%）和FIGO Ib1期（80.6%）。通过18F FDG PET-CT评估，肿瘤平均大小为26.4±10.8 mm，略低于临床检查测量的26.9 mm（t = 0.784），这两种方法之间存在显著相关性（r = 0.678，P < 0.001）。18F FDG PET-CT识别原发性肿瘤的总体准确率为88.7%，敏感性为86.8%，特异性为100.0%，阳性预测值为100.0%，阴性预测值为56.2%。术中检查显示总体准确率相同，但敏感性更高（98.1%），特异性更低（33.3%）。对于18F FDG PET-CT，与组织病理学检查的一致性水平良好（Kappa 0.656），而对于术中检查，一致性为中等（Kappa 0.409）。关于淋巴结评估，18F FDG PET-CT的准确率为82.2%，敏感性为53.8%，特异性为89.8%。术中检查显示准确率较低（66.1%），但敏感性较高（76.9%）。18F FDG PET-CT的Kappa值表明一致性中等（0.449），而术中检查显示一致性较差（0.282）。
总之，18F FDG PET-CT在早期宫颈癌术前分期中显示出显著有效性，在检测原发性肿瘤和微转移方面具有更高的准确性，特别是在预测淋巴结转移方面，从而提高诊断准确性并为治疗决策提供依据。
