PET/CT双时相显像在预测宫颈癌淋巴结转移中的价值  

Value of PET/CT biphasic imaging in predicting lymph node metastasis of cervical carcinoma

作　　者：周魏薇 宋丽萍 ZHOU Weiwei;SONG Liping.(Department of Nuclear Medicine, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121000, China)

机构地区：[1]锦州医科大学附属第一医院核医学科,辽宁锦州121000

出　　处：《临床肿瘤学杂志》2022年第3期232-237,共6页Chinese Clinical Oncology

摘　　要：目的探讨PET/CT双时相显像在预测宫颈癌淋巴结转移中的价值。方法回顾性分析2019年1月至2021年7月行PET/CT早期及延迟显像(双时相)的97例宫颈癌患者202枚淋巴结的影像学资料,测量早期显像淋巴结代谢参数SUVmaxL_(1)、SUVmean、SUVpeak、MTV、TLG、长短径比(L/D)、病灶SUVmaxT、腹主动脉SUVmaxA、肝脏SUVmaxH及延迟显像淋巴结代谢参数SUVmaxL_(2),计算各相应比值及△SUVmax(SUVmaxL_(2)-SUVmaxL_(1))、溜滞指数(RI)。比较各参数在淋巴结转移组(n=42)与非转移组(n=160)之间的差异,联合传统诊断标准行Logistic多因素回归分析,分别建立联合预测诊断模型,绘制受试者工作特征(ROC)曲线并比较诊断效能。结果淋巴结转移组与非转移组SUVmaxL_(1)、SUVmean、SUVpeak、MTV、TLG、L/D、SUVmaxL_(2)、△SUVmax、RI、SUVmaxL_(1)/T、SUVmaxL_(1)/A和SUVmaxL_(1)/H的差异均有统计学意义(P<0.001)。Logistic多因素回归分析显示,SUVpeak、L/D,传统PET/CT诊断标准和SUVmaxL_(2)为影响宫颈癌淋巴结转移的独立因素。传统PET/CT诊断标准的曲线下面积(AUC)为0.839,灵敏度为67.7%,特异度为87.5%;单时像联合预测诊断模型的AUC为0.915,灵敏度、特异度分别为83.3%和85.6%;双时相联合预测诊断模型的AUC为0.995,灵敏度、特异度分别为97.6%和98.7%。单时相联合预测诊断模型的AUC高于传统PET/CT诊断标准,双时相联合预测诊断模型的AUC高于传统PET/CT诊断标准,双时相联合预测诊断模型的AUC大于单时像联合预测模型,差异均有统计学意义(P<0.05)。结论单时相及双时相联合预测诊断模型诊断宫颈癌淋巴结转移的效能均高于传统诊断标准,同时双时相联合预测诊断模型的诊断效能显著高于单时相联合预测诊断模型。Objective To investigate the value of PET/CT biphasic imaging in predicting lymph node metastasis of cervical carcinoma.Methods We retrospectively analyzed 202 lymph nodes from January 2019 to July 2021 in 97 patients with cervical carcinoma who underwent surgery and had preoperative PET/CT for early and delayed imaging(duplex).The metabolic parameters of lymph nodes in early imaging,such as SUVmaxL_(1),SUVmean,SUVpeak,MTV,TLG,length-short diameter ratio(L/D),SUVmaxT of lesions,SUVmaxA of abdominal aorta,SUVmaxH of liver,and SUVmaxL_(2) of lymph nodes in delayed imaging were measured.The corresponding ratios,△SUVmax(SUVmaxL_(2)-SUVmaxL_(1))and retention index(RI)were calculated.The differences of each parameter between lymph node metastasis group(n=42)and non-metastasis group(n=160)were compared.Multivariate regression analysis was performed in combination with traditional diagnostic criteria to establish a combined predictive diagnostic model.Receiver operating characteristic(ROC)curve was used to compare the diagnostic efficacy.Results SUVmaxL_(1),SUVmean,SUVpeak,MTV,TLG,L/D,SUVmaxL_(2),△SUVmax,RI,SUVmaxL_(1)/T,SUVmaxL_(1)/A and SUVmaxL_(1)/H were significantly different between metastasis and non-metastasis groups,and Logistic multi-factor regression analysis showed that SUVpeak,L/D,conventional PET/CT diagnostic criteria and SUVmaxL_(2) were independent risk factors for lymph node metastasis of cervical cancer;the area under curve(AUC)of conventional PET/CT diagnostic criteria was 0.839,with a sensitivity of 67.7%and specificity of 87.5%;the AUC of single-temporal combined predictive diagnostic model was 0.915,with a sensitivity and specificity of 83.3%and 85.6%,respectively;the AUC of dual-temporal combined predictive diagnostic model was 0.995,with a sensitivity and specificity of 97.6%and 98.7%,respectively.The AUC of the single-temporal combined predictive diagnostic model was higher than that of the conventional PET/CT diagnostic criteria,the AUC of the dual-temporal combined predictive diagnostic mo

关 键 词：宫颈癌 PET/CT双时相显像 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]