자궁경부암에서 치료 전 FDG PET을 이용한 예후 예측 (Prediction of Prognosis using Pretreatment FDG PET in Uterine Cervical Carcinoma) |
Author |
장홍주, 최준영, 김영환, 박정미, 이경한, 이제호, 김병태, |
Hong-Joo Jang, M.D., Joon Young Choi, M.D., Young Hwan Kim, M.D.,Jung Mi Park M.D., Kyung-Han Lee M.D., Je Ho Lee M.D.1 and Byung-Tae Kim M.D. |
Affiliation |
성균관대학교 의과대학 삼성서울병원 핵의학과, 산부인과 Departments of Nuclear Medicine and Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea |
Abstract |
Purpose: In uterine cervical cancer, it is clinically important to predict prognosis on initial staging. We
investigated whether abnormally increased FDG uptake of lymph nodes and peak SUV of primary tumor on
initial FDG PET can predict prognosis after treatment in cervical cancer patients. Materials and Methods:
Subjects were 74 newly diagnosed cervical cancer patients (50±12yr). Whole body PET was performed
after an injection of F-18 FDG. Peak SUV was measured in the primary cervical tumor. Images were
interpreted by two nuclear medicine physicians. Follow-up for the disease-free survival was done in all
patients. Survival analysis was done by using the Kaplan-Meier method, and a Logrank test was used to
compare survival. Cox regression analysis was followed to find independent predictive factors. Results:
Recurrence occurred in 13 patients. In univariate analysis, advanced FIGO stage, large size of primary
tumor, positive lymph node on MRI or CT, and positive lymph node on PET were significant prognostic
factors to predict recurrence. Peak SUV and cell type of tumor failed to show any significant correlation with
disease-free survival. In multivariate analysis, positive lymph node on PET (Exp(β)=6.416, p=0.002) and on
CT or MRI (Exp(β)=5.711, p=0.026) were independent prognostic factors for predicting recurrence.
Conclusion: In uterine cervical cancer, lymph node metastasis of pretreatment FDG PET is the best
independent prognostic factor for predicting recurrence. But, peak SUV was not significant prognostic factor. |
Keyword |
F-18 Fluorodeoxyglucose, Positron Emission Tomography, Uterine Cervical Carcinoma |
Full text Article |
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