Primary tumor SUVmax on preoperative FDG-PET/CT is a prognostic indicator in stage IA2-IIB cervical cancer patients treated with radical hysterectomy
Primary tumor SUVmax on preoperative FDG-PET/CT is a prognostic indicator in stage IA2-IIB cervical cancer patients treated with radical hysterectomy
复制标题
DOI：
10.3892/mco.2016.953
复制
发表时间：
2016-09-01
影响因子：
1.2
通讯作者：
Ino, Kazuhiko
中科院分区：
文献类型：
--
作者：
Yagi, Shigetaka;Yahata, Tamaki;Ino, Kazuhiko
本研究的目的是探讨在手术切除的宫颈癌中，原发肿瘤在正电子发射断层扫描/计算机断层扫描（PET/CT）上摄取F-18-氟-2-脱氧-D-葡萄糖（FDG）的预后价值。共有59例IA 2-IIB期宫颈癌患者接受了术前FDG-PET/CT，随后进行了根治性子宫切除术和淋巴结切除术。测量原发肿瘤的最大标准化摄取值（SUVmax），并分析SUVmax与临床病理因素或患者预后之间的关系。SUVmax在晚期、淋巴结转移、淋巴管间隙受累和肿瘤较大的患者中显著较高。使用从受试者工作特征曲线分析获得的OS最佳截止值7.36和PFS最佳截止值5.59，高SUVmax患者的总生存期（OS）和无进展生存期（PFS）显著低于低SUVmax患者。同样，在39例IB期患者中，高SUVmax患者的OS和PFS显著较低，OS和PFS的临界值分别为7.90和6.69。最后，多变量分析显示，原发性肿瘤的SUVmax是所有患者和仅IB期患者PFS受损的独立预后因素。这些结果表明，术前PET/CT的高SUVmax与接受根治性子宫切除术的患者的不良临床结局相关，这表明原发肿瘤的SUVmax可能是接受根治性治疗的早期浸润性宫颈癌的预后指标。
The objective of the present study was to investigate the prognostic value of F-18-fluoro-2-deoxy-D-glucose (FDG) uptake by primary tumors on positron emission tomography/computed tomography (PET/CT) in surgically resectable cervical cancer. A total of 59 patients with stage IA2-IIB cervical cancer who underwent preoperative FDG-PET/CT, followed by radical hysterectomy and lymphadenectomy, were included in the study. The maximum standardized uptake value (SUVmax) of the primary tumor was measured, and the association between the SUVmax and clinicopathological factors or patient outcomes was analyzed. The SUVmax was significantly higher in patients with an advanced stage, lymph node metastasis, lymph-vascular space involvement and large tumors. The overall survival (OS) and progression-free survival (PFS) of patients with a high SUVmax were significantly lower compared with patients with a low SUVmax, using an optimal cut-off value of 7.36 for OS and 5.59 for PFS obtained from receiver operating characteristic curve analysis. Similarly, OS and PFS in patients with a high SUVmax were significantly lower in 39 patients with stage IB using a cut-off value of 7.90 and 6.69 for OS and PFS, respectively. Finally, multivariate analyses showed that the SUVmax of the primary tumor was an independent prognostic factor for impaired PFS in all patients and those with stage IB alone. These findings demonstrated that a high SUVmax on preoperative PET/CT was correlated with unfavorable clinical outcomes in patients receiving radical hysterectomy, suggesting that the SUVmax of the primary tumor may be a prognostic indicator for surgically-treated, early-stage invasive cervical cancer.