【摘要】 目的:探讨¹⁸F-氟脱氧葡萄糖PET-CT(¹⁸F-FDG PET-CT)在诊断国际妇产科联盟（FIGO）ⅠA2^ⅡA期宫颈癌原发灶和盆腔淋巴结转移中的临床价值。方法:回顾性分析91例FIGOⅠA2^ⅡA期宫颈癌患者的临床资料。计算PET-CT诊断宫颈癌原发灶的敏感度,并比较转移性淋巴结与非转移性淋巴结的长径、短径和最大标准摄取值（SUVmax）。通过受试者工作特征（ROC）曲线和曲线下面积（AUC）确定短径和SUVmax诊断淋巴结转移的最佳分界值,并计算其诊断盆腔淋巴结转移的敏感度、特异度和准确度。结果:91例宫颈癌患者中,PET-CT检查阳性89例,PET-CT诊断宫颈癌原发灶的敏感度为96.7%。转移性淋巴结和非转移性淋巴结的短径分别为（6.50±2.31）mm和（4.21±1.49）mm,SUVmax分别为4.56±3.34和1.92±1.41,组间比较差异有统计学意义（t=4.855和31.685,均P<0.05）。淋巴结短径和SUVmax诊断淋巴结转移的AUC分别为0.802和0.861,最佳分界值分别为5.5 mm和2.05。以短径≥5.5 mm且SUVmax≥2.05为诊断标准,诊断单个淋巴结转移的敏感度为85.0%,特异度为93.0%,准确度为86.8%。结论:PET-CT诊断ⅠA2^ⅡA宫颈癌原发病灶的敏感度高,对盆腔淋巴结转移也具有较高的诊断价值,以短径≥5.5 mm且SUVmax≥2.05作为转移性淋巴结诊断标准时准确性最高。更多还原

【Abstract】 Objective: To assess the value of ¹⁸F-fluorodeoxyglucose(¹⁸F-FDG)positron emission tomography-CT（PET-CT） in detection of primary tumor and pelvic lymph node metastasis in International Federation of Gynecology and Obstetrics（FIGO）stages ⅠA2-ⅡA cervical cancer. Methods: The clinical data of 91 patients with FIGO stages ⅠA2-ⅡA cervical cancer were retrospectively analyzed. The sensitivity of ¹⁸F-FDG PET-CT in detection of cervical cancer was calculated. The long diameter, short diameter and SUVmax were compared between metastatic lymph nodes（ MLN） and non-metastatic lymph nodes（NMLN）. The optimal cut-off values of different indexes were determined by receiver operating characteristic（ROC） curve and area under curve（AUC）, and the sensitivity,specificity and accuracy were calculated. Results :¹⁸F-FDG PET-CT examinations were positive in 89 patients（89/91, 96.7%）. The short diameters of NMLN and MLN were（6. 50 ± 2. 31） mm and（ 4. 21 ± 1.49） mm（t =4. 855, P <0. 05）; the SUVmax of NMLN and MLN were 4.56±3. 34 and1.92 ±1.41（t=31.685,P < 0.05）. ROC AUCs of the short diameter and SUVmax in diagnosis of metastatic lymph nodes were 0. 802 and 0. 861. Taken short diameter5.05 mm and SUVmax≥2.05 as cut-off values, the corresponding sensitivity, specificity and accuracy in diagnosis of metastatic lymph nodes were 85.0%, 93. 0% and 86. 8%,respectively. Conclusion : ¹⁸F-FDG PET-CT is sensitive to detect primary lesion and pelvic lymph node metastases in FIGO stages ⅠA2-Ⅱ A cervical cancer, and the highest diagnostic accuracy may be obtained by taking short diameter≥5.05 mm and SUVmax≥2.05 as the standard.更多还原