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

Yıl 2019, Cilt: 3 Sayı: 9, 681 - 684, 01.09.2019
https://doi.org/10.28982/josam.619609

Öz

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.

Kaynakça

  • 1. Lortet-Tieulet J, Ferlay J, Bray F, Jemal A. International Patterns and Trends in Endometrial Cancer Incidence, 1978–2013. J Natl Cancer Inst. 2017;110:354-61.
  • 2. Denschlag DU, Emons G. The diagnosis and treatment of endometrial cancer: progress and controversies. Dtsch Arztebl Int. 2011;108:571-7.
  • 3. Tran AQ, Gehrig P. Recent Advances in Endometrial Cancer. F1000Research. 2017;6:81.
  • 4. Uharcek P. Prognostic factors in endometrial carcinoma. J Obstet Gynaecol Res. 2008;34:776-83.
  • 5. Tschernichovsky R, Diver EJ, Schorge JO, Goodman A. The Role of Lymphadenectomy Versus Sentinel Lymph Node Biopsy in Early-stage Endometrial Cancer: A Review of the Literature. Am J Clin Oncol. 2016;39:516-21.
  • 6. Nayyar N, Lakhwani P, Goel A, Pande PK, Kumar K. The Futility of Systematic Lymphadenectomy in Early-Stage Low-grade Endometrial Cancer. Indian J Surg Oncol. 2018;9:204-10.
  • 7. Kyrgiou M, Swart AM, Qian W, Warwick J. A Comparison of Outcomes Following Laparoscopic and Open Hysterectomy With or Without Lymphadenectomy for Presumed Early-Stage Endometrial Cancer: Results From the Medical Research Council ASTEC Trial. Int J Gynecol Cancer. 2015;25:1424-36.
  • 8. El-Agwany AS, Meleis MH. Value and best way for detection of Sentinel lymph node in early stage endometrial cancer: Selective lymphadenectomy algorithm. Eur J Obstet Gynecol Reprod Biol. 2018;225:35-9.
  • 9. Soneji ND, Bharwani N, Ferri A, Stewart V, Rockall A. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results? Eur Radio. 2018;28:4725-34.
  • 10. Kim HJ, Cho A, Yun M, Kim YT, Kank WJ. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann Nucl Med. 2016;30:104-13.
  • 11. Sala E, Rockall AG, Freemen SJ, Mitchell DG, Reinhod C. The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology. 2013;266:717-40.
  • 12. Bollineni VR, Ytre-Hauge S, Bollineni-Balabay O, Salvesen HB, Haldorsen IS. High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature. J Nucl Med. 2016;57:879-85.
  • 13. Sager O, Dincoglan F, Demiral S, Uysal B, Gamsiz H, Elcim Y, et al. Utility Of Molecular Imaging With 2-Deoxy-2-[Fluorine-18] Fluoro-D-Glucose Positron Emission Tomography (18f-Fdg Pet) For Small Cell Lung Cancer (Sclc): A Radiation Oncology Perspective. Curr Radiopharm. 2018.
  • 14. Beinat C, Haywood T, Chen YS, Patel CB, Alam IS, Murty S, et al. The Utility of [(18)F]DASA-23 for Molecular Imaging of Prostate Cancer with Positron Emission Tomography. Mol Imaging Biol. 2018;20:1015-24.
  • 15. Gambhir SS, Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2:683-93.
  • 16. Kitajima K, Suenaga Y, Ueno Y, Maeda T, Ebina Y, Yamada H, et al. Preoperative risk stratification using metabolic parameters of (18)F-FDG PET/CT in patients with endometrial cancer. Eur J Nucl Med Mol Imaging. 2015;42:1268-75.
  • 17. Dolanbay M, Ozcelik B, Abdulrezzak U, Serin İS, Uludag S. F-18 fluoro-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in planning of surgery and sentinel lymph node screening in vulvar cancers. Arch Gynecol Obstet. 2016;293:1319-24.
  • 18. Picchio M, Mangili G, Samanes Gajate AM, De Marzi P, Spinapolice EG, Mapelli P, et al. High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging. Nucl Med Commun. 2010;31:506-12.
  • 19. Chang MC, Chen JH, Liang JA, Yang KT, Cheng KY, Kao CH. 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis. European Journal of Radiology. 2012;81:3511-7.
  • 20. Atri M, Zhang Z, Dehdashti F, Lee SI, Marques H, Ali S, et al. Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial. Radiology. 2017;283:450-9.
  • 21. Lee SI, Russell AH. Performance of 18F-FDG PET/CT in Endometrial Cancer. American Journal of Roentgenology. 2008;191:W210.
  • 22. Crivellaro C, Signorelli M, Guerra L, De Ponti E, Pirovano C, Fruscio R, et al. Tailoring systematic lymphadenectomy in high-risk clinical early stage endometrial cancer: the role of 18F-FDG PET/CT. Gynecol Oncol. 2013;130:306-11.
  • 23. Signorelli M, Guerra L, Buda A, Picchio M, Mangili G, Dell'Anna T, et al. Role of the integrated FDG PET/CT in the surgical management of patients with high risk clinical early stage endometrial cancer: detection of pelvic nodal metastases. Gynecol Oncol. 2009;115:231-5.
  • 24. Suga T, Nakamoto Y, Saga T, Higashi T, Hamanaka Y, Tatsumi M, et al. Clinical value of FDG-PET for preoperative evaluation of endometrial cancer. Ann Nucl Med. 2011;25:269-75.
  • 25. Nakamura K, Hongo A, Kodoma J, Hiramatsu Y. The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer. Gynecol Oncol. 2011;123:82-7.
  • 26. Nogami Y, Banno K, Irie H, Iida M, Kisu I, Masugi Y, et al. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it. Jpn J Clin Oncol. 2014;45:26-34.
  • 27. H Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, et al. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol. 2004;95:546-51.
  • 28. Antonsen SL, Loft A, Fisker R, Nielsen AL, Andersen ES, Høgdall E, et al. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients. Gynecol Oncol. 2013;129:298-303.
  • 29. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, et al. Lymph Node Metastasis in Patients with Clinical Early-Stage Cervical Cancer: Detection with Integrated FDG PET/CT. Radiology. 2006;238:272-9.
  • 30. Reinhardt, MJ, Ehritt-Braun C, Vogelgesang D. Metastatic Lymph Nodes in Patients with Cervical Cancer: Detection with MR Imaging and FDG PET. Radiology. 2001;218:776-82.
  • 31. Sironi S, Messa C, Mangili G. Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings. Radiology. 2004;233:433-40.

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

Yıl 2019, Cilt: 3 Sayı: 9, 681 - 684, 01.09.2019
https://doi.org/10.28982/josam.619609

Öz

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.

Kaynakça

  • 1. Lortet-Tieulet J, Ferlay J, Bray F, Jemal A. International Patterns and Trends in Endometrial Cancer Incidence, 1978–2013. J Natl Cancer Inst. 2017;110:354-61.
  • 2. Denschlag DU, Emons G. The diagnosis and treatment of endometrial cancer: progress and controversies. Dtsch Arztebl Int. 2011;108:571-7.
  • 3. Tran AQ, Gehrig P. Recent Advances in Endometrial Cancer. F1000Research. 2017;6:81.
  • 4. Uharcek P. Prognostic factors in endometrial carcinoma. J Obstet Gynaecol Res. 2008;34:776-83.
  • 5. Tschernichovsky R, Diver EJ, Schorge JO, Goodman A. The Role of Lymphadenectomy Versus Sentinel Lymph Node Biopsy in Early-stage Endometrial Cancer: A Review of the Literature. Am J Clin Oncol. 2016;39:516-21.
  • 6. Nayyar N, Lakhwani P, Goel A, Pande PK, Kumar K. The Futility of Systematic Lymphadenectomy in Early-Stage Low-grade Endometrial Cancer. Indian J Surg Oncol. 2018;9:204-10.
  • 7. Kyrgiou M, Swart AM, Qian W, Warwick J. A Comparison of Outcomes Following Laparoscopic and Open Hysterectomy With or Without Lymphadenectomy for Presumed Early-Stage Endometrial Cancer: Results From the Medical Research Council ASTEC Trial. Int J Gynecol Cancer. 2015;25:1424-36.
  • 8. El-Agwany AS, Meleis MH. Value and best way for detection of Sentinel lymph node in early stage endometrial cancer: Selective lymphadenectomy algorithm. Eur J Obstet Gynecol Reprod Biol. 2018;225:35-9.
  • 9. Soneji ND, Bharwani N, Ferri A, Stewart V, Rockall A. Pre-operative MRI staging of endometrial cancer in a multicentre cancer network: can we match single centre study results? Eur Radio. 2018;28:4725-34.
  • 10. Kim HJ, Cho A, Yun M, Kim YT, Kank WJ. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer. Ann Nucl Med. 2016;30:104-13.
  • 11. Sala E, Rockall AG, Freemen SJ, Mitchell DG, Reinhod C. The added role of MR imaging in treatment stratification of patients with gynecologic malignancies: what the radiologist needs to know. Radiology. 2013;266:717-40.
  • 12. Bollineni VR, Ytre-Hauge S, Bollineni-Balabay O, Salvesen HB, Haldorsen IS. High Diagnostic Value of 18F-FDG PET/CT in Endometrial Cancer: Systematic Review and Meta-Analysis of the Literature. J Nucl Med. 2016;57:879-85.
  • 13. Sager O, Dincoglan F, Demiral S, Uysal B, Gamsiz H, Elcim Y, et al. Utility Of Molecular Imaging With 2-Deoxy-2-[Fluorine-18] Fluoro-D-Glucose Positron Emission Tomography (18f-Fdg Pet) For Small Cell Lung Cancer (Sclc): A Radiation Oncology Perspective. Curr Radiopharm. 2018.
  • 14. Beinat C, Haywood T, Chen YS, Patel CB, Alam IS, Murty S, et al. The Utility of [(18)F]DASA-23 for Molecular Imaging of Prostate Cancer with Positron Emission Tomography. Mol Imaging Biol. 2018;20:1015-24.
  • 15. Gambhir SS, Molecular imaging of cancer with positron emission tomography. Nat Rev Cancer. 2002;2:683-93.
  • 16. Kitajima K, Suenaga Y, Ueno Y, Maeda T, Ebina Y, Yamada H, et al. Preoperative risk stratification using metabolic parameters of (18)F-FDG PET/CT in patients with endometrial cancer. Eur J Nucl Med Mol Imaging. 2015;42:1268-75.
  • 17. Dolanbay M, Ozcelik B, Abdulrezzak U, Serin İS, Uludag S. F-18 fluoro-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in planning of surgery and sentinel lymph node screening in vulvar cancers. Arch Gynecol Obstet. 2016;293:1319-24.
  • 18. Picchio M, Mangili G, Samanes Gajate AM, De Marzi P, Spinapolice EG, Mapelli P, et al. High-grade endometrial cancer: value of [(18)F]FDG PET/CT in preoperative staging. Nucl Med Commun. 2010;31:506-12.
  • 19. Chang MC, Chen JH, Liang JA, Yang KT, Cheng KY, Kao CH. 18F-FDG PET or PET/CT for detection of metastatic lymph nodes in patients with endometrial cancer: A systematic review and meta-analysis. European Journal of Radiology. 2012;81:3511-7.
  • 20. Atri M, Zhang Z, Dehdashti F, Lee SI, Marques H, Ali S, et al. Utility of PET/CT to Evaluate Retroperitoneal Lymph Node Metastasis in High-Risk Endometrial Cancer: Results of ACRIN 6671/GOG 0233 Trial. Radiology. 2017;283:450-9.
  • 21. Lee SI, Russell AH. Performance of 18F-FDG PET/CT in Endometrial Cancer. American Journal of Roentgenology. 2008;191:W210.
  • 22. Crivellaro C, Signorelli M, Guerra L, De Ponti E, Pirovano C, Fruscio R, et al. Tailoring systematic lymphadenectomy in high-risk clinical early stage endometrial cancer: the role of 18F-FDG PET/CT. Gynecol Oncol. 2013;130:306-11.
  • 23. Signorelli M, Guerra L, Buda A, Picchio M, Mangili G, Dell'Anna T, et al. Role of the integrated FDG PET/CT in the surgical management of patients with high risk clinical early stage endometrial cancer: detection of pelvic nodal metastases. Gynecol Oncol. 2009;115:231-5.
  • 24. Suga T, Nakamoto Y, Saga T, Higashi T, Hamanaka Y, Tatsumi M, et al. Clinical value of FDG-PET for preoperative evaluation of endometrial cancer. Ann Nucl Med. 2011;25:269-75.
  • 25. Nakamura K, Hongo A, Kodoma J, Hiramatsu Y. The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer. Gynecol Oncol. 2011;123:82-7.
  • 26. Nogami Y, Banno K, Irie H, Iida M, Kisu I, Masugi Y, et al. The efficacy of preoperative positron emission tomography-computed tomography (PET-CT) for detection of lymph node metastasis in cervical and endometrial cancer: clinical and pathological factors influencing it. Jpn J Clin Oncol. 2014;45:26-34.
  • 27. H Horowitz NS, Dehdashti F, Herzog TJ, Rader JS, Powell MA, Gibb RK, et al. Prospective evaluation of FDG-PET for detecting pelvic and para-aortic lymph node metastasis in uterine corpus cancer. Gynecol Oncol. 2004;95:546-51.
  • 28. Antonsen SL, Loft A, Fisker R, Nielsen AL, Andersen ES, Høgdall E, et al. SUVmax of 18FDG PET/CT as a predictor of high-risk endometrial cancer patients. Gynecol Oncol. 2013;129:298-303.
  • 29. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, et al. Lymph Node Metastasis in Patients with Clinical Early-Stage Cervical Cancer: Detection with Integrated FDG PET/CT. Radiology. 2006;238:272-9.
  • 30. Reinhardt, MJ, Ehritt-Braun C, Vogelgesang D. Metastatic Lymph Nodes in Patients with Cervical Cancer: Detection with MR Imaging and FDG PET. Radiology. 2001;218:776-82.
  • 31. Sironi S, Messa C, Mangili G. Integrated FDG PET/CT in Patients with Persistent Ovarian Cancer: Correlation with Histologic Findings. Radiology. 2004;233:433-40.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma makalesi
Yazarlar

Mustafa Taş 0000-0001-7183-0026

Adem Yavuz Bu kişi benim 0000-0003-4191-4004

Mehmet Dolanbay 0000-0002-8332-1568

Eser Kaya Bu kişi benim 0000-0003-2931-9974

Gökalp Öner Bu kişi benim 0000-0002-6270-4340

Bülent Özçelik 0000-0003-3257-8088

Yayımlanma Tarihi 1 Eylül 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 3 Sayı: 9

Kaynak Göster

APA Taş, M., Yavuz, A., Dolanbay, M., Kaya, E., vd. (2019). Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. Journal of Surgery and Medicine, 3(9), 681-684. https://doi.org/10.28982/josam.619609
AMA Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. Eylül 2019;3(9):681-684. doi:10.28982/josam.619609
Chicago Taş, Mustafa, Adem Yavuz, Mehmet Dolanbay, Eser Kaya, Gökalp Öner, ve Bülent Özçelik. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine 3, sy. 9 (Eylül 2019): 681-84. https://doi.org/10.28982/josam.619609.
EndNote Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B (01 Eylül 2019) Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. Journal of Surgery and Medicine 3 9 681–684.
IEEE M. Taş, A. Yavuz, M. Dolanbay, E. Kaya, G. Öner, ve B. Özçelik, “Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT”, J Surg Med, c. 3, sy. 9, ss. 681–684, 2019, doi: 10.28982/josam.619609.
ISNAD Taş, Mustafa vd. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine 3/9 (Eylül 2019), 681-684. https://doi.org/10.28982/josam.619609.
JAMA Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. 2019;3:681–684.
MLA Taş, Mustafa vd. “Preoperative Detection of Lymph Node Metastasis in Endometrial Cancer: The Role of 18-FDG PET/CT”. Journal of Surgery and Medicine, c. 3, sy. 9, 2019, ss. 681-4, doi:10.28982/josam.619609.
Vancouver Taş M, Yavuz A, Dolanbay M, Kaya E, Öner G, Özçelik B. Preoperative detection of lymph node metastasis in endometrial cancer: The role of 18-FDG PET/CT. J Surg Med. 2019;3(9):681-4.