Endometrial kanserde preoperatif lenf nodu metastazi tespiti: Endometrial kanserde 18-FDG PET/BT'nin rolü

Year 2019, , 681 - 684, 01.09.2019

Mustafa Taş , Adem Yavuz Mehmet Dolanbay , Eser Kaya Gökalp Öner Bülent Özçelik

https://doi.org/10.28982/josam.619609

Abstract

Amaç: Fluorine-18 2-floro-2-deoksi-D-glukoz (FDG) pozitron emisyon tomografisi (PET)/ BT görüntüleme tekniği, lokalizasyonun ve fonksiyonel görüntülemenin avantajlarını birleştirdiğinden, endometrial kanserli hastalarda lenf nodu (LN) metastazlarının tespiti için tercih edilen bir yöntem haline gelmiştir. Bu çalışmada 18F-FDG PET/BT görüntüleme sonuçlarının, endometrial kanserin lenf nodu metastazının belirlenmesindeki etkinliğini araştırmayı amaçladık. 

Yöntemler: Bu çalışma 2009-2015 yılları arasında yapılan retrospektif kohort bir çalışmadır. Çalışma grubu kliniğimize başvuran ve endometriyal kanser tanısı alan tüm kadınlardan (n=135) oluşmaktaydı. Çalışmaya, ameliyat öncesi 18F-FDG PET/BT çekilen ve LN diseksiyonu yapılan hastaları dahil edildi. Bu yöntemin lend nodu metastazını belirlemede etkinliği değerlendirildi. Değerlendirmeler ve karşılaştırmalar altın standard patolojik tanı yöntemleriyle yapıldı. 

Bulgular: Lenf nodu metastazlarının tanımlanmasında 18F-FDG PET/BT yönteminin %76 duyarlılık, %80 özgüllük, %46.34 pozitif prediktif değeri ve %93.62 negatif prediktif değeri gösterdiği bulundu. Genel tanısal doğruluk ise %79,26 idi.

Sonuç: Analizlerimiz, 18F-FDG PET/BT'nin, endometriyal kanser hastalarında lenf nodu metastazı açısından yüksek negatif prediktif değere sahip olduğunu ve bu hastalarda lenf nodu metastazı araştırmada uygulanabilir bir görüntüleme yöntemi olduğunu göstermiştir.

Keywords

Endometrial kanser, Lenf nodu metastazı, 18F-FDG-PET/BT, Prognoz

Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT

Abstract

Aim: Fluorine-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT imaging technique combines the advantages of localization and functional imaging, and thus has become a preferred method for detection of metastases to the lymph nodes (LN) of patients with endometrial cancer. The aim of this study was to evaluate the efficacy of 18F-FDG PET/CT imaging results in the detection of metastasis of endometrial cancer to lymph nodes.

Methods: This is a retrospective cohort study conducted between 2009 and 2015. The study group consisted of females who were admitted to our clinic and diagnosed with endometrial cancer (n=135). We included patients who underwent LN dissection with pre-operative 18F-FDG PET / CT imaging, and evaluated the capability of this method in terms of its effectiveness in determining metastases to the lymph nodes. Assessments and comparisons were performed with gold-standard pathological methods. 

Results: The 18F-FDG PET/CT method for identification of lymph node metastases had a sensitivity of 76%, a specificity of 80%, a positive predictive value of 46.34% and a negative predictive value of 93.62%. The overall diagnostic accuracy was 79.26%.

Conclusion: Our analysis suggests that 18F-FDG PET/CT has a high negative predictive value with regards to lymph node metastasis in endometrial cancer and may be used effectively in evaluating lymph node metastasis in this cohort.

Keywords

Endometrial cancer, Lymph node metastasis, 18F- FDG-PET/CT, Ratio, Prognosis

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