Endometrium kanserinde preoperatif görüntüleme bulgularıyla nihai patolojinin karşılaştırılması

Yıl 2024, Cilt: 17 Sayı: 3, 341 - 350

Özcan Yılmaz , Görkem Ülger , Ali Yıldızbakan , Hasan Hüsnü Yüksek , Hakan Aytan , Şevki Göksun Gökulu

Öz

Amaç: Bu çalışmada preoperatif görüntülemesi yapılmış olan endometrium kanserli hastaların görüntüleme sonuçlarıyla postoperatif nihai patoloji sonuçlarını retrospektif olarak karşılaştırmayı amaçladık. Yöntem: 1 Ocak 2019 - 4 Ağustos 2022 tarihleri arasında Mersin Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Anabilim Dalı Jinekoloji-Onkoloji polikliniğinde takip ve tedavi edilen preoperatif görüntülemesi olan toplam 123 endometrium kanserli kadın hasta çalışmaya dâhil edilmiştir. Hastaların preoparetif görüntüleme sonuçları ve nihai patoloji sonuçları karşılaştırılmıştır. Bulgular: Preoperatif 10 MRG, 67 BT, 46 PET/BT görüntülemesi olan hastaların nihai patoloji sonuçlarıyla yapılan karşılaştırmalar sonucunda görüntülemenin çalışmamızda bulduğumuz sensitivite değeri literatürden düşük olup, lenf nodu metastazı ve uzak metastaz açısından PET/BT’nin sensitivite, spesifite, pozitif ve negatif prediktif değerleri MRG ve BT’ye kıyasla daha yüksek bulunmuştur. Ayrıca çalışmamızda ameliyat öncesi görüntüleme yöntemleri ile pelviste tespit edilen en büyük lenf nodu boyutunun 15.5 mm ve üzeri olmasının, pelviste lenf nodu metastazı varlığını %60 sensitivite ve %70,8 spesifisite ile öngörebildiği bulunmuştur. Sonuç: Endometrium kanserinde uterus dışına yayılmış hastalık varlığında PET/BT görüntülemenin hastaların operasyon öncesi lenf nodu tutulumunu göstermede, klinik evresinin tespitinde ve operasyonun şeklinin ve genişliğinin belirlenmesinde önemli yeri vardır. Ayrıca çalışmamızda bulduğumuz pelvik lenf nodu metastazı açısından görüntülemedeki pelvik lenf nodu boyutu cut-off değeri yapılacak klinik evrelemede klinisyenlere yol gösterebilir.

Anahtar Kelimeler

Endometrium kanseri, patoloji, preoparetif görüntüleme

Comparison of preoperative imaging findings and final postoperative pathology in endometrium cancer

Öz

Aim: In this study, we aimed to retrospectively compare the imaging results of patients with endometrial cancer who underwent preoperative imaging with the final postoperative pathology results. Method: A total of 123 female patients with endometrial cancer with preoperative imaging were followed and treated in the Gynecology-Oncology outpatient clinic of the Department of Obstetrics and Gynecology, Mersin University Faculty of Medicine Hospital between 1 January 2019 and 4 August 2022 were included in the study. Preoperative imaging results and final pathology results were compared. Results: As a result of comparisons with the final pathology results of patients with preoperative 10 MRI, 67 CT, and 46 PET/CT imaging, the sensitivity value of imaging was lower than the literature, but the sensitivity, specificity, positive and negative predictive values of PET/CT were higher in terms of lymph node metastasis and distant metastasis compared to MRI and CT. In addition, our study found that the largest lymph node size of 15.5 mm or more detected by preoperative imaging methods in the pelvis predicted the presence of lymph node metastasis in the pelvis with a sensitivity of 60% and a specificity of 70.8%. Conclusion: In endometrial cancer, PET/CT imaging has an essential role in showing preoperative lymph node involvement, determining the clinical stage, and determining the type and extent of the operation in the presence of disease spread outside the uterus. In addition, the cut-off value of pelvic lymph node size in imaging for pelvic lymph node metastasis found in our study may guide clinicians in clinical staging.

Anahtar Kelimeler

Endometrial cancer, pathology, preoperative imaging

Kaynakça

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