ERKEN EVRE UTERİN SERVİKS KANSERLİ HASTALARDA PELVİK VE PARAAORTİK LENF NODU METASTAZLARININ SAPTANMASINDA 18F-FDG PET / BT'NİN TANISAL DEĞERİNİN BELİRLENMESİ To Determine the Diagnostic Value of 18F-FDG PET / CT in Detecting Pelvic and Paraaortic lymph Node Metastases in Patients with Early Stage Uterine Cervix Cancer.

Yıl 2019, Cilt: 9 Sayı: 4, 56 - 63, 27.12.2019

Mustafa Tas Adem Yavuz Eser Kaya Bülent Özçelik

Öz

ÖZET
Amaç: Bu çalışmanın amacı, erken evre uterin serviks kanserli hastalarda pelvik ve paraaortik lenf nodu
metastazlarının saptanmasında 18F-florodeoksiglukoz Pozitron Emisyon tomografisi / Bilgisayarlı Tomografi
(PET/BT) 'nin tanısal değerini belirlemekti.
Gereç ve Yöntem: Radikal histerektomi ve sistemik pelvik ve paraaortik lenf nodu diseksiyonu öncesi PET/
BT görüntülemesi yapılan erken evre uterin serviks kanserli 18 hasta çalışmaya dahil edildi. Lenf nodlarının
histopatolojik değerlendirmesi tanısal standart olarak kabul edildi ve PET/BT bulguları histopatolojik bulgularla
karşılaştırıldı.
Bulgular: 18 hastadan toplam 807 (577 pelvik - 230 paraaortik) lenf nodu örneklendi ve histopatolojik
incelemede 5 (% 28) hastada 10 (%1,2) nod (8 pelvik - 2 paraaortik) pozitif bulundu. Genel nod bazlı PET/
BT'nin duyarlılık, özgüllük, pozitif prediktif değer (PPV), negatif prediktif değer (NPV) ve doğruluğu sırasıyla %
10 (1/10), % 100 (797/797), %100 (1/1) % 99 (797/806) ve % 99 (798/807) idi.
Genel hasta bazlı PET/BT'nin duyarlılık, özgüllük, PPV, NPV ve doğruluğu sırasıyla %20 (1/5), %100 (13/13), %
100 (1/1), % 76 (13/17), %78 (14/18) idi.
Sonuç: Erken evre uterin serviks kanserli hastaların yönetiminde, mikrometastatik lenf nodu olan hastaların
PET / BT'de yanlış negatif olarak rapor edilebileceği akılda tutulmalıdır.
Anahtar Kelimeler: Erken evre uterin serviks kanseri; Preoperatif FDG PET/BT; Pelvik ve paraaortik lenf nodu
metastazı.
ABSTRACT
Objective: The aim of this study was to determine the diagnostic value of 18F-fluorodeoxyglucose Positron
Emission Tomography / Computed Tomography (PET / CT) in detection of pelvic and paraaortic lymph node
metastases in patients with early stage uterine cervix cancer.
Materials and Methods: 18 patients with early stage uterine cervix cancer who underwent PET / CT imaging
before radical hysterectomy and systemic pelvic and paraaortic lymph node dissection were included in the
study. Histopathological evaluation of lymph nodes was accepted as the diagnostic standard and PET/CT
findings were compared with histopathological findings.
Results: Of the total 807 (577 pelvic ve 230 para- aortic) lymph nodes sampled from 18 patients, and 10
(1,2%) nodes (8 pelvik ve 2 paraaortic) in 5 (28%) patients were positive for metastasis at histopathologic
examination. The overall node-based sensitivity, specificity, positive predictive value (PPV), negative predictive
value (NPV), and accuracy of PET/CT were 10% (1of 10), 100% (797 of 797), 100% (1 of 1), 99% (797 of 806),
and 99% (798 of 807), respectively. Meanwhile, the overall patient-based sensitivity, specificity, PPV, NPV,
and accuracy of PET/CT were 20% (1 of 5), 100% (13 of 13), 100% (1 of 1), 76% (13 of 17), and 78% (14 of 18),
respectively.
Conclusions: In the management of patients with early stage uterine cervix cancer, it should be kept in mind
that patients with micro-metastatic lymph nodes can be reported as false negative in PET / CT.
Key words: Early stage uterine cervix cancer; Preoperative PET / CT; Pelvic and paraaortic lymph node
metastasis

Anahtar Kelimeler

ERKEN EVRE UTERİN SERVİKS KANSERLİ HASTALARDA PELVİK VE PARAAORTİK LENF NODU METASTAZLARININ SAPTANMASINDA 18F-FDG PET / BT'NİN TANISAL DEĞERİNİN BELİRLENMESİ To Determine the Diagnostic Value of 18F-FDG PET / CT in Detecting Pelvic and Paraaortic lymph Node Metastases in Patients with Early Stage Uterine Cervix Cancer.

Kaynakça

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