中国实用妇科与产科杂志

中国实用妇科与产科杂志

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磁共振成像检查对早期宫颈癌分期价值研究

乔志伟a，王安娜a，王纯雁a，董雪b   

  1. 作者单位：辽宁省肿瘤医院，a.妇科，b.影像科，辽宁 沈阳 110042
  • 出版日期:2015-03-02 发布日期:2015-04-01
  • 通讯作者: 王纯雁

The value of MRI in staging of cervical cancer.

QIAO Zhi-wei , WANG An-na , WANG Chun-yan , DONG Xue.   

  1. Liaoning Cancer Hospital , Shengyang 110042 , China
  • Online:2015-03-02 Published:2015-04-01

摘要：

目的 探讨磁共振成像（MRI）在评估早期宫颈癌患者宫旁浸润、阴道受侵、淋巴结转移方面的价值。方法 选取2010-10-01至2013-01-31辽宁省肿瘤医院收治的48例因宫颈癌为病因首次就诊患者，以术后病理结果为金标准比较MRI、术前妇科三合诊、术中探查和剖视标本3种诊断方法在宫旁浸润、阴道受侵、淋巴结转移3个方面的价值，并以手术-病理分期为金标准对MRI分期及术前临床分期的准确度进行对比。结果 MRI在早期宫颈癌术前淋巴结转移诊断方面的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为65%、94%、85%、83%、83%，在宫旁浸润方面分别为50%、91%、33%、95%、88%，在阴道受侵方面分别为50%、78%、43%、82%、71%。妇科三合诊在早期宫颈癌宫旁浸润方面的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为0、100%、0、92%、92%、阴道受侵方面分别为75%、100%、100%、92%、94%。临床分期的整体准确度为81%，MRI分期的整体准确度为67%，临床-MRI分期的整体准确度为92%。结论 MRI在早期宫颈癌术前淋巴结转移诊断方面有良好的价值；在宫旁浸润、阴道受侵方面有较好的阴性预测值和特异度；将临床-MRI结合所得分期较单独运用两种诊断方法分期准确度有所提高。

关键词: 宫颈肿瘤 , 磁共振成像 , 肿瘤分期

Abstract:

Abstract： Objective To explore the diagnostic value of MRI in the evaluation of para- cervical infiltration, vagina involvement and lymph node involvement in the surgical treatment for patients with cervical cancer. Methods Forty-eight cases receiving surgical treatment were chosen in this study who were first visit patients as cervical cancer .Study the sensitivity, specificity, positive predictive value, negative predictive value, degree of accuracy in the assessment of paracervical infiltration, vagina involvement and lymph node involvement respectively using the postoperative pathology as the gold standard. And surgical - pathologic staging was wsed as gold standard to study the accuracy of MRI staging and preoperative clinical staging.Results For MRI in the surgical treatment of patients with cervical cancer with lymph node metastasis,the sensitivity,specificity, positive predictive value, negative predictive value,degree of accuracy were respectively 65%, 94%, 85%, 83% and 83%,for parametrial invasion the sensitivity,specificity, positive predictive value, negative predictive value, degree of accuracy were respectively 50%,91%,33%,95%,88%, for vaginal invasion the sensitivity, specificity, positive predictive value,negative predictive value,degree of accuracy were respectively 50%,78%,43%,82%,71% .Gynecological examination parametrial invasion in early stage cervical cancer sensitivity、specificity、 positive predictive value、 negative predictive value、degree of accuracy were respectively 0,100%,0、92%,92%,vaginal invasion the sensitivity,specificity, positive predictive value,negative predictive value and degree of accuracy were respectively 75%,100%,100%,92%、94%. The overall clinical staging accuracy was 81%, MRI staging overall accuracy was 67%, and clinical -MRI staging overall accuracy was 92%. Conclusions MRI has a big advantage for cervical cancer with lymph node metastasis;for those with parametrial invasion and vaginal invasion it has good negative predictive value and specificity.The MRI combined with clinical staging is better that the separate use of the two diagnostic methods in improving staging accuracy .

Key words: cerviad tumor, magnetic resonance imaging, neoplasm staging

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