Computed tomography in endometrial carcinoma
Computed tomography in endometrial carcinoma
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DOI：
10.1016/s0029-7844(99)00626-2
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发表时间：
2000-05-01
影响因子：
7.2
通讯作者：
Buller, RE
中科院分区：
文献类型：
--
作者：
Connor, JP;Andrews, JI;Buller, RE
目的：确定计算机断层扫描 (CT) 扫描对于术前检测子宫内膜癌患者宫外淋巴结疾病和术后复发性疾病的价值。方法：我们回顾了 1979 年至 1993 年间诊断的 702 名原发性子宫内膜癌女性的记录。将术前 CT 结果与病理结果进行比较，以评估淋巴结疾病。在临床可疑和常规情况下对术后 CT 的产量进行审查。结果：在 492 名符合分析资格的女性中，178 名 (36%) 总共进行了 326 次 CT 扫描。在 56 名接受术前 CT 扫描和淋巴结取样的女性中，淋巴结受累的阳性和阴性预测值分别为 50% 和 94%，敏感性和特异性分别为 57% 和 92%。术前 CT 检查结果仅改变了 6 名患者 (8%) 的治疗计划。 45 名无症状女性接受了 73 次常规 CT 扫描，只有 2 名（4.4%）通过 CT 诊断出复发。 37 名女性因怀疑复发而进行了 CT 扫描，其中 17 名 (46%) 得到证实。 Kaplan-Meyer 分析显示，通过 CT 扫描诊断出亚临床复发的女性没有生存优势。结论：常规术前 CT 扫描很少改变治疗，并且对淋巴结疾病的预测效果不佳。术后计算机断层扫描可能有助于发现和随访复发性疾病，但当 CT 发现亚临床复发时，生存率没有差异。因此，除非是为了评估症状，否则不应对任何患有子宫内膜癌的女性进行 CT 扫描。 （Obstet Gynecol 2000；95:692-6。(C) 2000 年，美国妇产科医师学会。）。
Objective: To determine the value of computed tomography (CT) scans for preoperatively detecting extrauterine-nodal disease and postoperative recurrent disease in patients with endometrial cancer.Methods: We reviewed records of 702 women with primary endometrial carcinoma that was diagnosed between 1979 and 1993. Preoperative CT findings were compared with pathologic findings to assess nodal disease. The yield of postoperative CT was reviewed in clinically suspicious and routine settings.Results: Among 492 women eligible for analysis, 178 (36%) had a total 326 CT scans. Among 56 women who had preoperative CT scans and lymph node samplings, positive and negative predictive values for nodal involvement were 50% and 94%, respectively, and sensitivity and specificity were 57% and 92%, respectively. Preoperative CT findings altered treatment plans in only six patients (8%). Forty-five asymptomatic women had 73 routine CT scans, and recurrence was diagnosed by CT in only two (4.4%). Thirty-seven women had CT scans for suspicion of recurrence, which was confirmed in 17 (46%). Kaplan-Meyer analysis showed no survival advantage in women with subclinical recurrences diagnosed by CT scan.Conclusion: Routine preoperative CT scanning rarely alters treatment and is a poor predictor of nodal disease. Computed tomography in the postoperative period might be helpful for detection and follow-up of recurrent disease, but there was no difference in survival when subclinical recurrence was found by CT. Thus, CT scanning of any woman with endometrial cancer should be discouraged unless it is to evaluate symptoms. (Obstet Gynecol 2000;95:692-6. (C) 2000 by The American College of Obstetricians and Gynecologists.).