^(18)F-FDG PET/CT纹理特征联合MMP-7表达预测早期宫颈癌盆腔淋巴结转移  

^(18)F-FDG PET/CT Texture Features Combined with MMP-7 Expression Predicting Pelvic Lymphatic Metastasis in Cervical Squamous Cell Carcinoma

作　　者：霍文礼 由英宁 卢再鸣[1] 孙洪赞[1] HUO Wenli;YOU Yingning;LU Zaiming(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang,Liaoning Province 110004,P.R.China)

机构地区：[1]中国医科大学附属盛京医院放射科,沈阳110004

出　　处：《临床放射学杂志》2021年第1期170-174,共5页Journal of Clinical Radiology

摘　　要：目的探讨氟代脱氧葡萄糖(^(18)F-FDG)正电子发射断层成像/X线计算机体层成像(PET/CT)图像纹理特征联合基质金属蛋白酶(MMP-7)在预测宫颈鳞癌(CSCC)患者盆腔淋巴结转移中的价值。方法根据国际妇产科联合学会(FIGO)宫颈癌分期系统,选取50例诊断为Ⅰa~Ⅱa期的CSCC患者,所有患者术前接受^(18)F-FDG PET/CT扫描。提取^(18)F-FDG PET/CT宫颈癌原发灶图像纹理特征,通过受试者工作特征曲线(ROC)评估纹理特征联合MMP-7表达水平对预测淋巴结转移的价值。结果盆腔淋巴结转移阳性患者MMP-7表达高于淋巴结转移阴性患者。直方图和灰度共生矩阵(GLCM)中得到的3个纹理特征:偏度(Inertia)、高灰度行程优势(HGLRE)、长行程高灰度优势(LRHGLE)联合预测淋巴结转移方面具有优越价值[曲线下面积(AUC)=0.950,P<0.05,95%CI 0.885~1.000,特异度为88.90%,敏感度为95.70%]。此外,纹理特征和MMP-7表达的组合能优化预测效能(AUC=0.968,P<0.05,95%CI 0.929~1.000,特异度为92.60%,敏感度为91.30%)。结论对于CSCC患者,可以通过纹理特征预测盆腔淋巴结转移,同时,纹理特征联合MMP-7表达提高了预测效能。Objective The purpose of this study was to investigate the value of 2-deoxy-2-^(18)F-fluoro-D-glucose positron emission tomography/computed tomography(^(18)F-FDG PET/CT) texture features combined with matrix metalloproteinase7(MMP-7) expression in predicting pelvic lymphatic metastasis in patients with cervical squamous cell carcinoma. Methods According to the International Society of Obstetrics and Gynecology(FIGO) Cervical Cancer Staging System, 50 patients with stage Ia-IIa cervical squamous cell carcinoma were selected.All patients underwent ^(18)F-FDG PET/CT scan before surgery.The texture features of ^(18)F-FDG PET/CT images were extracted and the value of texture features combined with MMP-7 expression levels in predicting lymphatic metastasis was assessed by receiver operating characteristic curve(ROC). Results MMP-7 expression was higher in patients with lymph node metastasis than in patients without lymph node metastasis.The homogenous texture feature-skewness obtained in the histogram has certain value in predicting lymphatic metastasis(AUC=0.950,P<0.05,95% CI 0.885-1.000,Specificity=88.90%,sensitivity=95.70%).At the same time, the combination of texture features and MMP-7 expression had significantly superior predictive value(AUC=0.968,P<0.05,95% CI 0.929-1.000,Specificity=92.60%,sensitivity=91.30%). Conclusion In patients with cervical squamous cell carcinoma, PLN metastasis can be predicted by the textural feature of homogeneity.Radiomic features in combination with the MMP-7 expression level improved the prediction accuracy.

关 键 词：宫颈鳞癌 纹理分析 正电子发射断层成像/X线计算机体层成像 基质金属蛋白酶 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]