ABSTRACT

Objectives: The aim of this study was to explore the predictive recurrence value of the PET/CT index and some clinical features in patients with IIB-IVA cervical cancer.

Methods: This was a retrospective analysis of 84 patients with cervical cancer who underwent 18 F-FDG PET/CT scans before treatment. MTV-s is the sum of the metabolic volume of the primary cervical lesion (MTV-C) and the metabolic volume of the pelvic and abdominal paravascular metastatic lymph nodes (MTV-LN). We analyzed the relationships between clinical characteristics (age, FIGO stage, pathological pattern, degree of differentiation, tumor size, presence of LN metastasis), PET/CT index (SUVmax-C, SUVmax-LN, MTV-C, MTV-LN, MTV-s), and recurrence of cervical cancer using the chi-square test; the ROC curve was used to determine the PET/CT boundary parameters; and the COX proportional risk model was used for univariate and multivariate analysis of clinical features and the PET/CT index. The survival curve was drawn using the Kaplan–Meier method, comparing different groups by the log-rank test.

Results: Eighty-four patients were included. During the observation period, 26 patients had tumor recurrence (31.0%). Univariate analysis showed that lymph node metastasis, lymph node SUVmax (SUVmax-LN), MTV-C, MTV-LN, and MTV-s were associated with PFS. MTV-s > 27.36 cm³ was an independent risk factor for PFS (P = 0.037). There were 41 patients with MTV-s > 27.36 cm³, and 19 of them had tumor recurrence (46.3%). There were 43 patients with MTV-s ≤ 27.36 cm³, 7 of whom had tumor recurrence (16.3%).

Conclusion: MTV-s can predict recurrence in patients with stage IIB-IVA cervical cancer, with a critical value of 27.36 cm³. PET/CT can help clinicians judge the prognosis of patients more comprehensively.

摘要

目的：本研究旨在探讨PET / CT指数在IIB-IVA子宫颈癌患者中的预测复发价值和一些临床特征。

方法：这是对84例宫颈癌患者的回顾性分析，这些患者在治疗前接受了18次F-FDG PET / CT扫描。MTV-s是原发性宫颈病变（MTV-C）的代谢量与盆腔和腹部血管旁转移性淋巴结（MTV-LN）的代谢量之和。我们分析了临床特征（年龄，FIGO分期，病理模式，分化程度，肿瘤大小，LN转移的存在），PET / CT指数（SUVmax-C，SUVmax-LN，MTV-C，MTV-LN， MTV）和使用卡方检验的子宫颈癌复发；用ROC曲线确定PET / CT边界参数；COX比例风险模型用于临床特征和PET / CT指数的单因素和多因素分析。使用Kaplan-Meier方法绘制生存曲线，

结果：84例患者被纳入研究。在观察期间，有26例肿瘤复发（31.0％）。单因素分析表明，淋巴结转移，淋巴结SUVmax（SUVmax-LN），MTV-C，MTV-LN和MTV-s与PFS相关。MTV-s> 27.36 cm ³是PFS的独立危险因素（P = 0.037）。MTV-s> 27.36 cm ^3的患者41例，其中19例复发（46.3％）。MTV-s≤27.36 cm ^3的患者43例，其中7例复发（16.3％）。

结论：MTV-s可以预测IIB-IVA期宫颈癌的复发，临界值为27.36 cm ³。PET / CT可以帮助临床医生更全面地判断患者的预后。