Risk factors and PET/CT diagnosis of pelvic lymph node metastasis in early-stage cervical cancer / 中国医学影像技术

ABSTRACT

Objective To explore risk factors of pelvic lymph node (PLN) metastasis in cervical cancer,and to observe the value of PET/CT in diagnosis of PLN metastasis with qualitative and semi-quantitative evaluation.Methods Clinical data of 206 patients with cervical cancer who underwent PLN dissection were respectively analyzed.The age and BMI of patients,pathological type,depth of invasion and International Federation of Gynecology and Obstetrics (FIGO) stage of tumor,serum SCC level,lymph node status of PET/CT and tumor SUVmax were analyzed with univariate analysis.Multivariate analysis was performed for indicators with statistically significant variables.The accuracy,sensitivity and specificity of PET/CT in diagnosis of PLN metastasis of cervical cancer were calculated.Besides,the ratios of lymph node 'S SUVmax (SUVmaxLN) to SUVmax of primary tumor (SUVmaxL/T),to liver (SUVmaxL/H) and to arota (SUVmaxL/A) were recorded.ROC curves were plotted,whereas the areas under curve (AUC) were calculated to confirm the best diagnostic cutoff value.Results Univariate analysis showed that age,BMI,pathological type,depth of invasion,FIGO stage,serum SCC level,lymph node status of PET/CT and tumor SUVmax were important factors of PLN metastasis (all P＜0.05).Multivariate analysis revealed that serum SCC levels,depth of invasion,lymph node status of PET/CT and tumor SUVmax were independent predictors of PLN metastasis (P＜0.05).The sensitivity,specificity and accuracy of PET/CT in diagnosis of PLN metastasis was 54.90％ (28/51),91.61％ (142/155) and 82.52％ (170/206),respectively.The sensitivity of SUVmaxLN =4.19 was higher than SUVmax =2.5.No significant difference of SUVmaxLN with SUVmaxL/T,with SUVmaxL/H nor with SUVmaxL/A was found.Conclusion Serum SCC levels,depth of invasion,lymph node status of PET/ CT and tumor SUVmax are independent predictors of PLN metastasis.PET/CT has certain value in qualitative and semiquantitative analysis of cervical cancer PLN metastasis.