Lymph node staging by positron emission tomography in patients with carcinoma of the cervix
Lymph node staging by positron emission tomography in patients with carcinoma of the cervix
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DOI：
10.1200/jco.2001.19.17.3745
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发表时间：
2001-09-01
影响因子：
45.3
通讯作者：
Dehdashti, F
中科院分区：
文献类型：
--
作者：
Grigsby, PW;Siegel, BA;Dehdashti, F
目的：本研究的目的是比较计算机断层扫描（CT）和正电子发射断层扫描（PET）的结果与[F-18]-氟-2-脱氧-D-葡萄糖（FDG）的淋巴结分期的宫颈癌患者，并评估影像学表现与预后的关系。我们回顾性比较了101例连续的宫颈癌患者的CT淋巴结分期和全身FDG-PET的结果。患者接受标准放疗和化疗（根据临床指征）治疗，每隔3个月观察一次，中位时间为15.4个月（范围：2.5至30个月）。Kaplan-Meier法评估无进展生存率。结果：CT显示20例（20%）盆腔淋巴结异常肿大，7例（7%）主动脉旁淋巴结异常肿大。PET显示盆腔淋巴结异常67例（67%），主动脉旁淋巴结异常21例（21%），锁骨上淋巴结异常8例（8%）。仅基于主动脉旁淋巴结状态的2年无进展生存率在CT阴性和PET阴性患者中为64%，在CT阴性和PET阳性患者中为18%，在CT阳性和PET阳性患者中为14%（P < .0001）。多变量分析表明，无进展生存的最重要的预后因素是存在阳性的主动脉旁淋巴结检测PET成像（P = .025）。结论：这项研究表明，FDG-PET检测异常淋巴结区域更经常比CT和PET的结果是一个更好的预测生存比CT的宫颈癌患者。(C)2001年，美国临床肿瘤学会。
Purpose: The aim of this study was to compare the results of computed tomography (CT) and positron emission tomography (PET) with [F-18]-fluoro-2-deoxy-D-glucose (FDG) for lymph node staging in patients with carcinoma of the cervix and to evaluate the relationship of the imaging findings to prognosis.Patients and Methods. We retrospectively compared the results of CT lymph node staging and whole-body FDG-PET in 101 consecutive patients with carcinoma of the cervix. Patients were treated with standard irradiation and chemotherapy (as clinically indicated) and observed at 3-month intervals for a median of 15.4 months (range, 2.5 to 30 months). Progression-free survival was evaluated by the Kaplan-Meier method.Results: CT demonstrated abnormally enlarged pelvic lymph nodes in 20 (20%) and para-aortic lymph nodes in seven (7%) of the 101 patients. PET demonstrated abnormal FDG uptake in pelvic lymph nodes in 67 (67%), in para-aortic lymph nodes in 21 (21%), and in supraclavicular lymph node in eight (8%). The 2-year progression-free survival, based solely on para-aortic lymph node status, was 64% in CT-negative and PET-negative patients, 18% in CT-negative and PET-positive patients, and 14% in CT-positive and PET-positive patients (P < .0001). A multivariate analysis demonstrated that the most significant prognostic factor for progression-free survival was the presence of positive para-aortic lymph nodes as detected by PET imaging (P = .025).Conclusion: This study demonstrates that FDG-PET detects abnormal lymph node regions more often than does CT and that the findings on PET are a better predictor of survival than those of CT in patients with carcinoma of the cervix. (C) 2001 by American Society of Clinical Oncology.