Stadler Carla Linn, Strandberg Sara N
Hospital of Sundsvall, Sundsvall, Sweden.
University Hospital of Umeå, Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden.
Eur J Obstet Gynecol Reprod Biol X. 2025 Mar 6;26:100376. doi: 10.1016/j.eurox.2025.100376. eCollection 2025 Jun.
Accurate staging of uterine cervical cancer (UCC) is crucial for treatment guidance and prognostic predictions. This study investigated the added value of conventional diagnostic imaging for different histopathological subtypes of UCC by comparing clinical staging according to International Federation of Gynaecology and Obstetrics staging system (cFIGO) and radiological staging (rFIGO) with histopathological staging (pFIGO) as reference.
26 consecutive patients with UCC from the retrospective part of the PRODIGYN study (ethical approval number 2022-04207-01; NCT05855941) were included in the present study. Data from study participants was collected from radiological and histopathological records 2016-2022 at the University hospital of Umeå. Staging was assessed according to the FIGO 2018 staging system. Statistical analysis included descriptive statistics and Cohen's weighted kappa coefficient (κ) for calculation of agreement between cFIGO and rFIGO, and between rFIGO and pFIGO.
With rFIGO staging, more advanced disease stages were found in 67 % (8/12 patients with known cFIGO). Poor agreement was found between cFIGO and rFIGO (κ =0.057) and between rFIGO and pFIGO (κ= 0169). Among the patients with squamous cell carcinoma (SCC) positive for human papilloma virus (HPV+), 67 % (4/6) were assigned a higher stage by rFIGO compared to cFIGO. For the single patients with HPV-negative SCC and HPV status unknown SCC, both were upstaged by rFIGO. In the case of adenocarcinomas, 67 % (2/3) of the patients were assigned a higher stage with rFIGO.
In primary staging of UCC, rFIGO leads to substantial up-staging compared to cFIGO, without obvious differences in subtypes.
子宫颈癌（UCC）的准确分期对于治疗指导和预后预测至关重要。本研究通过比较根据国际妇产科联盟分期系统（cFIGO）的临床分期和放射学分期（rFIGO）与以组织病理学分期（pFIGO）为参照，探讨传统诊断成像对不同组织病理学亚型UCC的附加价值。
本研究纳入了PRODIGYN研究回顾性部分的26例连续UCC患者（伦理批准号2022-04207-01；NCT05855941）。研究参与者的数据收集自于2016年至2022年乌梅奥大学医院的放射学和组织病理学记录。根据FIGO 2018分期系统进行分期评估。统计分析包括描述性统计以及用于计算cFIGO与rFIGO之间、rFIGO与pFIGO之间一致性的Cohen加权kappa系数（κ）。
采用rFIGO分期时，在已知cFIGO分期的12例患者中有67%（8/12）被发现处于更晚期疾病阶段。cFIGO与rFIGO之间（κ =0.057）以及rFIGO与pFIGO之间（κ= 0.169）的一致性较差。在人乳头瘤病毒（HPV）阳性的鳞状细胞癌（SCC）患者中，与cFIGO相比，rFIGO将67%（4/6）的患者分期上调。对于HPV阴性SCC和HPV状态未知SCC的单一患者，两者均被rFIGO上调分期。在腺癌病例中，67%（2/3）的患者被rFIGO分配到更高分期。
在UCC的初始分期中，与cFIGO相比，rFIGO导致大量分期上调，各亚型之间无明显差异。
