18F-FDG PET/CT在宫颈癌分期及淋巴结转移评估中的应用

Application of 18F-FDG PET/CT in the evaluation of cervical cancer staging and lymph node metastasis

目的探究18氟-2脱氧-D-葡萄糖(18F-FDG)正电子发射断层显像/X线计算机体层成像仪(PET/CT)在宫颈癌分期及淋巴结转移评估中的应用价值。方法回顾性分析2017年5月至2018年5月在金华市人民医院接受18F-FDG PET/CT检查的53例宫颈癌患者的影像学资料,以手术病理结果为金标准评估18F-FDG PET/CT对宫颈癌分期及淋巴结转移的诊断价值。结果 18F-FDG PET/CT诊断宫颈癌原发病灶的SUV max曲线下面积(AUC)为0.78(Z=4.50,P<0.05),诊断界值为4.21,对应的敏感度、特异度、准确度为77.36%、88.68%、83.02%;18F-FDG PET/CT分期诊断准确率86.79%略高于MRI分期诊断准确率79.25%,但差异无统计学意义(χ~2=1.07,P>0.05);18F-FDG PET/CT诊断宫颈癌盆腔淋巴结转移SUV max曲线下面积(AUC)为0.82(Z=6.00,P<0.05),诊断界值为3.36,对应的敏感度、特异度、准确度为82.35%、77.78%、79.25%。结论 18F-FDG PET/CT显像对宫颈癌分期及淋巴结转移评估具重要临床意义,可正确指导临床诊疗方案的制定与预后评估。

Objective To explore the value of 18 F fluoro-2 deoxy-D-glucose(18 F-FDG) positron emission tomography/X-ray computed tomography(PET/CT) in the evaluation of cervical cancer staging and lymph node metastasis. Methods From May 2017 to May 2018, the imaging data of 53 patients with cervical cancer who underwent 18 F-FDG PET/CT in Jinhua People’s Hospital were retrospectively analyzed. The surgical pathological results were taken as gold standard to evaluate the diagnostic value of 18 F-FDG PET/CT for cervical cancer staging and lymph node metastasis. Results The SUV max area under curve(AUC) of 18 F-FDG PET/CT in diagnosis primary cervical cancer was 0.78(Z=4.50, P<0.05) and the diagnostic threshold was 4.21. The sensitivity, specificity and accuracy were 77.36%, 88.68% and 83.02% respectively. The accuracy of 18 F-FDG PET/CT in diagnosing staging was 86.79%, which was slightly higher than that of MRI(79.25%), but there was no significant difference(χ~2=1.07,P>0.05). The SUV max area under curve(AUC) of 18 F-FDG PET/CT in diagnosing lymph node metastasis in pelvic cavity was 0.82(Z=6.03,P<0.05), and the diagnostic threshold was 3.36. The sensitivity, specificity and accuracy were 82.35%, 77.78% and 79.25%, respectively. Conclusion The examination of 18 F-FDG PET/CT has important clinical significance for the evaluation of cervical cancer staging and lymph node metastasis. And it can correctly guide the formulation of clinical diagnosis and treatment regimens and the prognosis evaluation.