MRI術前評估在子宮内膜癌患者行盆腔淋巴結清掃決策中的作用  

The role of preoperative evaluation with MRI in decision-making for pelvic lymph node dissection in patients with endometrial cancer

作　　者：梁海琪 曾偉科 馬春林 李純科 陳清葉 侯鈴旋 洪宇 LIANG Hai Qi;ZENG Wei Ke;MA Chun Lin;LI Chun Ke;CHEN Qing Ye;HOU Ling Xuan;HONG Yu(Department of Obstetrics and Gynecology,Kiang Wu Hospital,Macao,China;Department of Radiology,Memorial Hospital of Sun Yat-sen University;Department of Radiology,Kiang Wu Hospital,Macao,China)

机构地区：[1]澳門鏡湖醫院婦產科,中國澳門 [2]中山大學孫逸仙紀念醫院放射科 [3]澳門鏡湖醫院放射科,中國澳門

出　　处：《镜湖医学》2024年第2期25-28,共4页MEDICAL JOURNAL OF KIANG WU

基　　金：澳門科學技術發展基金(0003/2022/A和0001/2024/RIA1)。

摘　　要：目的評估術前磁共振成像(MRI)檢查在子宮内膜癌患者行盆腔淋巴結清掃(PLND)決策中的作用。方法納入2016年1月~2024年3月間在本院婦產科住院行手術治療的子宮内膜癌患者,收集臨床資料,以術後病理結果為金標準,評估術前MRI檢查對子宮肌層浸潤和盆腔淋巴結轉移的診斷效果。結果共納入84例,MRI評估子宮深肌層浸潤(MI≥50%)的敏感度、特異度和準確率分别為60.7%,91.1%和81.0%,MRI評估盆腔淋巴結轉移的敏感度、特異度和準確率分别為27.3%,89.3%和79.1%。當以MRI檢查提示子宮深肌層浸潤、盆腔淋巴結轉移或兩者聯合來預測病理診斷盆腔淋巴結轉移時,MRI提示深肌層浸潤作為預測指標的Youden指數最大,為0.495。結論在本院,與單獨依據MRI診斷盆腔淋巴結轉移相比,根據MRI診斷深肌層浸潤(MI≥50%)而行選擇性PLND是更為可靠的術前評估方案。Objective To evaluate the role of preoperative magnetic resonance imaging(MRI)in decision-making for pelvic lymph node dissection(PLND)in patients with endometrial cancer.Methods From January 2016 to March 2024,patients with endometrial cancer who underwent surgical treatment in the Obstetrics and Gynecology Ddepartment of Kiang Wwu Hospital were enrolled in this study.Clinical materials were collected and postoperative pathological results were used as the gold standard to evaluate the diagnostic efficacy of preoperative MRI examination for uterine myometrial infiltration and pelvic lymph node metastasis.Results 84 patients with endometrial cancer were adopted for final analysis.The sensitivity,specificity,and accuracy of MRI in evaluating deep uterine myometrial infiltration(MI≥50%)were 60.7%,91.1%,and 81.0%,respectively.The sensitivity,specificity,and accuracy of MRI in evaluating pelvic lymph node metastasis were 27.3%,89.3%,and 79.1%,respectively.When MRI indicating deep myometrial infiltration,pelvic lymph node metastasis,or a combination of both were applied to predict pathological diagnosis of pelvic lymph node metastasis,the Youden index of MRI indicating deep myometrial infiltration as the predictive indicator is the highest,at 0.495.Conclusion In our hospital,compared with MRI diagnosis of pelvic lymph node metastasis,selective PLND based on MRI diagnosis of deep myometrial infiltration is a more reasonable preoperative evaluation plan.

关 键 词：磁共振成像 術前評估 子宮内膜癌 盆腔淋巴結清掃 

分 类 号：R73[医药卫生—肿瘤]