基于FIGO 2018分期的宫颈癌MRI术前分期与术后病理分期对照研究  

Comparative study of preoperative MRI staging and pathological staging of cervical cancer:based on FIGO 2018 staging

作　　者：张添辉 龙曦 陈思萍 王丽琼 林政 王惠良 范伟雄[1] ZHANG Tianhui;LONG Xi;CHEN Siping;WANG Liqiong;LIN Zheng;WANG Huiliang;FAN Weixiong(Department of MRI,the People’s Hospital of Meizhou,Meizhou,Guangdong Province 514031,China;Department of Obstetrics and Gynecology,the People’s Hospital of Meizhou,Meizhou,Guangdong Province 514031,China;Department of Pathology,the People’s Hospital of Meizhou,Meizhou,Guangdong Province 514031,China)

机构地区：[1]梅州市人民医院磁共振科,广东梅州514031 [2]梅州市人民医院妇产科,广东梅州514031 [3]梅州市人民医院病理科,广东梅州514031

出　　处：《实用放射学杂志》2022年第2期278-281,284,共5页Journal of Practical Radiology

摘　　要：目的探讨基于国际妇产科联盟(FIGO)2018分期评估宫颈癌MRI术前分期与术后病理分期的一致性及其诊断准确性.方法回顾性收集经手术病理证实的109例宫颈癌患者资料.2位放射科医师在不知病理结果的情况下依据FIGO 2018分期对MRI图像进行阅片及分期.采用Kap pa检验评价宫颈癌MRI术前分期与术后病理分期的一致性.以术后病理分期为标准,计算MRI术前分期的诊断敏感度、特异度、阳性预测值、阴性预测值及准确度.结果基于FIGO 2018分期,宫颈癌MRI术前分期结果为ⅠB1期18例、ⅠB2期46例、ⅠB3期3例、ⅡA1期25例、ⅡA2期4例及ⅢC1期13例.术后病理分期为ⅠB1期17例、ⅠB2期46例、ⅠB3期7例、ⅡA1期19例、ⅡA2期2例及ⅢC1期18例.MRI术前分期与术后病理分期结果的一致性良好(Kap pa值=0.624,P<0.001).MRI术前评估宫颈癌FIGO 2018分期的诊断准确度分别为ⅠB1期99.1%、ⅠB2期81.7%、ⅠB3期96.3%、ⅡA1期81.7%、ⅡA2期98.2%及ⅢC1期88.1%.结论基于FIGO 2018分期标准,宫颈癌MRI术前分期与术后病理分期具有良好的一致性,且具有较高的诊断准确性.Objective To evaluate the diagnostic efficiency of preoperative MRI staging and its consistency with pathological staging for cervical cancer based on International Federation of Gynecology and Obstetrics(FIGO)2018 staging.Methods 109 patients with cervical cancer confirmed by surgery and pathology were retrospectively studied.Two radiologists who without pathological finding performed staging in MRI according to the FIGO 2018 staging.Kap pa test was used to compare the preoperative MRI staging with the pathological staging.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the MRI were calculated with the pathological results as the reference standard.Results The number of patients with MRI stagingⅠB1,ⅠB2,ⅠB3,ⅡA1,ⅡA2 andⅢC1 were 18,46,3,25,4 and 13,with pathological stagingⅠB1,ⅠB2,ⅠB3,ⅡA1,ⅡA2 andⅢC1 were 17,46,7,19,2 and 18,respectively.The MRI staging had good consistency with the pathological staging(Kappa=0.624,P<0.001).The accuracy of MRI for stagingⅠB1 was 99.1%,ⅠB2 was 81.7%,ⅠB3 was 96.3%,ⅡA1 was 81.7%,ⅡA2 was 98.2%andⅢC1 was 88.1%,respectively.Conclusion The preoperative MRI staging of cervical cancer has good consistency with the postoperative pathological staging,and has high diagnostic efficacy for the FIGO 2018 staging.

关 键 词：宫颈癌 磁共振成像 分期 

分 类 号：R737.33[医药卫生—肿瘤] R445.2[医药卫生—临床医学]