国际妇产科联盟分期修订对术前MRI预测子宫内膜癌分期准确性的影响  

Magnetic resonance staging accuracy for endometrial carcinoma based on different FIGO staging systems

作　　者：张英丽[1] 丁国军[2] 石磊[2] 陈雅卿[1] 

机构地区：[1]浙江省肿瘤医院妇瘤科,杭州310022 [2]浙江省肿瘤医院放射科,杭州310022

出　　处：《中华医学杂志》2013年第19期1486-1489,共4页National Medical Journal of China

摘　　要：目的了解子宫内膜癌国际妇产科联盟（FIGO）分期系统修订对MRI术前预测子宫内膜癌分期准确性的影响。方法对2006年8月至2010年7月在浙江省肿瘤医院接受初次手术治疗、术前行MRI的95例子宫内膜癌患者进行回顾性分析。根据不同的FIGO分期系统（1988、2009年）对子宫内膜癌MRI图像进行分期，以对应的手术病理分期为金标准，评价不同分期系统下MRI术前预测子宫内膜癌分期的敏感度、特异度、诊断一致率、阳性预测值和阴性预测值。结果按1988年FIGO分期系统，术前MRI进行子宫内膜癌分期的诊断一致率为：Ⅰ期83．2％，Ⅱ期86．3％，Ⅲ期92．6％；IA、IB和IC期诊断敏感度分别为51．8％、76．5％和50．0％，特异度分别为85．3％、55．7％和95．4％；ⅡA、ⅡB期的诊断敏感度仅12．5％、20．0％，特异度则为97．7％、100．0％。按2009年FIGO分期系统，Ⅰ、Ⅱ和Ⅲ期的诊断一致率分别为88．4％，96．8％和91．6％；IA、IB期的诊断敏感度分别为97．1％、55．6％，特异度分别为57．7％、95．3％；Ⅱ期的诊断敏感度和特异度分别40．0％和100．0％。结论依据2009年FIGO分期系统，术前MRI诊断Ⅰ、Ⅱ期子宫内膜癌的准确性明显提高。Objective To evaluate MR accuracy for staging endometrial carcinoma with different FIGO staging systems. Methods Between August 2006 and July 2010, 95 women underwent surgery for endometrial carcinoma. In each patient, endometrial carcinoma was staged with magnetic resonance （MR） findings based on the old FIGO staging system and then repeated according to the new FIGO staging system for comparisons. Histopathologic findings were used as a golden standard to compare the sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results The accuracy of MRI in the staging of endometrial carcinoma stage Ⅰ, Ⅱ and Ⅲ with the old FIGO staging system were 83.2% , 86.3% and 92.6% versus 88.4% , 96. 8% and 91.6% respectively with the new FIGO staging criteria. According the old FIGO staging system, the sensitivity of stage Ⅰ A, Ⅰ B and Ⅰ C were 51.8% , 76. 5% and 50.0% and the specificity 85.3% , 55.7% and 95.4% respectively; the sensitivity of stage Ⅱ A and ⅡB were merely 12. 5% and 20. 0% and the specificity 97.7% and 100. 0%. With the new FIGO staging criteria, the above indices were 97.1%, 55.6%, 57.7%, 95.3%, 40.0% and 100.0% respectively. Conclusion With new FIGO staging system versus the old one, the accuracy of MR imaging in the preoperative staging of endometrial carcinoma increases.

关 键 词：子宫内膜癌 磁共振成像 肿瘤分期 

分 类 号：R737[医药卫生—肿瘤] R44[医药卫生—临床医学]