18F-FDG PET/CT semi-quantitative parameters combined with SCC-Ag in predicting lymph node metastasis in stage I-II cervical cancer

Cheng-Zhi Jiang; Kai Zheng; Yan-Yin Zhang; Jian Yang; Hui Ye; Xiang Peng

doi:10.3389/fonc.2024.1278464

¹⁸F-FDG PET/CT semi-quantitative parameters combined with SCC-Ag in predicting lymph node metastasis in stage I-II cervical cancer

Front Oncol. 2024 Jun 14:14:1278464. doi: 10.3389/fonc.2024.1278464. eCollection 2024.

Authors

Cheng-Zhi Jiang¹, Kai Zheng¹, Yan-Yin Zhang¹, Jian Yang¹, Hui Ye¹, Xiang Peng¹

Affiliation

¹ Department of PET-CT Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.

Abstract

Objective: To explore the value of ¹⁸F-fluordeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) semi-quantitative parameters of primary tumor combined with squamous cell carcinoma antigen (SCC-Ag) in predicting lymph node metastasis (LNM) of cervical cancer (FIGO 2018 stage I-II).

Materials and methods: A total of 65 patients with stage I-II cervical cancer underwent ¹⁸F-FDG PET/CT were included in our study. Comparing the primary tumor ¹⁸F-FDG PET/CT semi-quantitative parameters and SCC-Ag between the LNM group and the non-LNM group. Logistic regression and receiver operating characteristic (ROC) were used to analyze the value of ¹⁸F-FDG PET/CT metabolic parameters and SCC-Ag in predicting LNM.

Results: There were 14 and 51 patients were classified as having LNM and NLNM. The semi-quantitative parameters, including the maximum standardized uptake value (SUVmax), the mean standardized uptake value (SUVmean), the peak standardized uptake value (SUVpeak), the total lesion glycolysis (TLG), the metabolic tumor volume (MTV) of the tumor and SCC-Ag were all significantly higher in LNM than in NLNM (SUVmax, 16.07 ± 7.81 vs 11.19 ± 4.73, SUVmean, 9.16 ± 3.48 vs 6.29 ± 2.52, SUVpeak, 12.70 ± 5.26 vs 7.65 ± 3.26, MTV, 22.77 ± 12.36 vs 7.09 ± 5.21, TLG, 211.01 ± 154.25 vs 43.38 ± 36.17, SCC-Ag, 5.39 ± 4.56 vs 2.13 ± 2.50, all p<0.01). Logistic regression analysis showed that TLG was an independent predictor of LNM in stage I-II cervical cancer (OR 1.032, 95% CI 1.013-1.052, p<0.01). Moreover, the predictive value of TLG combined with SUVpeak and SCC-Ag increased and the area under the curve increased compared SUVpeak and SCC-Ag.

Conclusion: ¹⁸F-FDG PET/CT semi-quantitative parameters and SCC-Ag have promise for assessing LNM in stage I-II cervical cancer. TLG of primary tumor provides independent and increasing values in predicting LNM in stage I-II cervical cancer.

Keywords: cervical cancer; lymph node metastasis; positron emission tomography/computed tomography; squamous cell carcinoma-antigen; total lesion glycolysis.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by Wu Jieping Medical Foundation Clinical Research Project (NO. 320.6750.2020-06-24 to HY) and Hunan Cancer Hospital Climb Plan (NO. QH2021001 to C-ZJ).