文章：

子宫内膜癌局部分期中MRI检测≥pT1b期病变的性能评估

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer

原文发布日期：13 March 2024

DOI: 10.3390/cancers16061142

类型: Article

开放获取: 是

英文摘要：

Magnetic resonance imaging (MRI) can be used for the preoperative local staging of endometrial cancer (EC). The presence of ≥pT1b disease (i.e., tumor invasion in ≥50% of the myometrium, into the cervical stroma or spread outside the uterus) has important prognostic value and implications for the decision to perform lymphadenectomy. The purpose of this study was to assess the performance of MRI for the detection of ≥pT1b disease and to evaluate whether tumor size measured via MRI was predictive for ≥pT1b disease, independent of imaging signs of deep invasion. MRI T-staging and tumor diameter and volume were correlated with histopathology of the hysterectomy specimen in 126 patients. MRI had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 70.0%, 83.3%, 79.2%, 75.3% and 77.0%, respectively, for the detection of ≥pT1b disease. A tumor diameter of ≥40 mm and volume of ≥20 mL measured via MRI were predictive for ≥pT1b disease at rates of 78.3% and 87.1%, respectively. An EC size of at least 5 mm upon MRI was predictive for ≥pT1b disease in more than 50% of cases. Our results support the use of MRI in the preoperative staging of EC and suggest including size criteria in EC staging guidelines.

摘要翻译： 

磁共振成像（MRI）可用于子宫内膜癌（EC）的术前局部分期。≥pT1b期病变（即肿瘤侵犯≥50%的肌层、宫颈间质或扩散至子宫外）的存在具有重要的预后价值，并对是否进行淋巴结清扫术的决策具有指导意义。本研究旨在评估MRI检测≥pT1b期病变的性能，并评估通过MRI测量的肿瘤大小是否能独立于深部浸润的影像学征象，预测≥pT1b期病变。在126例患者中，将MRI的T分期、肿瘤直径和体积与子宫切除标本的组织病理学结果进行相关性分析。MRI检测≥pT1b期病变的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为70.0%、83.3%、79.2%、75.3%和77.0%。通过MRI测量的肿瘤直径≥40 mm和体积≥20 mL分别以78.3%和87.1%的比率预测≥pT1b期病变。在超过50%的病例中，MRI上EC大小至少为5 mm可预测≥pT1b期病变。我们的结果支持在EC术前分期中使用MRI，并建议在EC分期指南中纳入大小标准。

原文链接：

Performance of MRI for Detection of ≥pT1b Disease in Local Staging of Endometrial Cancer