切换至 "中华医学电子期刊资源库"
高级检索
中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2023, Vol. 19 ›› Issue (01) : 113 -119. doi: 10.3877/cma.j.issn.1673-5250.2023.01.016

综述

影像学技术在宫颈癌术前临床分期中的应用进展
董双1, 李晓莹1, 孙立涛2, 田家玮1,†()   
  1. 1哈尔滨医科大学附属第二医院超声医学科，哈尔滨　150086
    2浙江省人民医院，杭州　314408
  • 收稿日期:2022-10-08 修回日期:2023-01-05 出版日期:2023-02-01
  • 通信作者: 田家玮

Advances in the application of imaging techniques in preoperative staging of cervical cancer

Shuang Dong1, Xiaoying Li1, Litao Sun2, Jiawei Tian1,†()   

  1. 1Department of Ultrasound Medicine, the Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Helongjiang Province, China
    2Zhejiang Provincial People′s Hospital, Huangzhou 314408, Zhejiang Province, China
  • Received:2022-10-08 Revised:2023-01-05 Published:2023-02-01
  • Corresponding author: Jiawei Tian
  • Supported by:
    National Natural Science Foundation of China(82071929)
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

董双, 李晓莹, 孙立涛, 田家玮. 影像学技术在宫颈癌术前临床分期中的应用进展[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 113-119.

Shuang Dong, Xiaoying Li, Litao Sun, Jiawei Tian. Advances in the application of imaging techniques in preoperative staging of cervical cancer[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(01): 113-119.

宫颈癌是女性生殖系统最常见的恶性肿瘤。宫颈癌分期标准于2018年根据临床实践进行了更新，此前宫颈癌是唯一采用临床分期的妇科恶性肿瘤，新版宫颈癌分期系统首次提出将病理学检查结果及影像学检查结果用于临床分期。近年，随着影像学技术的发展，影像学技术在宫颈癌术前临床分期中的作用越来越大。笔者拟就影像学技术在宫颈癌术前临床分期中的作用进行综述。

关键词: 宫颈肿瘤, 肿瘤分期, 磁共振成像, 正电子发射断层显像术, 体层摄影术，X线计算机, 超声检查, 妇女

Cervical cancer is the most common malignant tumor of female reproductive system. Cervical cancer staging criteria based on clinical practice was updated in 2018, after cervical cancer is the only with clinical stage gynecological malignant tumor, only the latest version of cervical cancer staging system for the first time put forward the results of pathology and the imaging results for staging, in recent years, with the development of imaging techniques, imaging techniques in cervical cancer treatment before checking the application more and more. This article reviews the role of imaging techniques in preoperative staging of cervical cancer.

Key words: Uterine cervical neoplasms, Neoplasm staging, Magnetic resonance imaging, Positron-emission tomography, Tomography, X-ray computed, Ultrasonography, Women
[1]
Balcacer P, Shergill A, Litkouhi B. MRI of cervical cancer with a surgical perspective: staging, prognostic implications and pitfalls[J]. Abdom Radiol (NY), 2019, 44(7): 2557-2571. DOI: 10.1007/s00261-019-01984-7.
[2]
Sung H, Ferlay J, Siegel RL, et al: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
[3]
Bhatla N, Berek JS, Cuello Fredes M, et al. Revised FIGO staging for carcinoma of the cervix uteri[J]. Int J Gynaecol Obstet, 2019, 145(1): 129-35.DOI：10.1002/ijgo.12749.
[4]
Bhatla N, Aoki D, Sharma DN, et al. Cancer of the cervix uteri: 2021 update[J/OL]. Int J Gynaecol Obstet, 2021, 155 (Suppl 1): 28-44. DOI: 10.1002/ijgo.13865.
[5]
Salib M, Russell J, Stewart V, et al. 2018 FIGO staging classification for cervical cancer: added benefits of imaging[J]. Radiographics, 2020, 40(6)：1807-1822. DOI: 10.1148/rg.2020200013.
[6]
张恒，曲海波. 宫颈癌淋巴结转移的影像学诊断[J/OL]. 中华妇幼临床医学杂志(电子版), 2021, 17(5) : 503-509. DOI: 10.3877/cma.j.issn.1673-5250.2021.05.002.
[7]
Woo S, Atun R, Ward ZJ, et al. Diagnostic performance of conventional and advanced imaging modalities for assessing newly diagnosed cervical cancer: systematic review and Meta-analysis[J]. Eur Radiol, 2020, 30(10): 5560-5577. DOI: 10.1007/s00330-020-06909-3.
[8]
Manganaro L, Lakhman Y, Bharwani N, et al. Staging, recurrence and follow-up of uterine cervical cancer using MRI: updated Guidelines of the European Society of Urogenital Radiology after revised FIGO staging 2018[J]. Eur Radiol, 2021, 31(10): 7802-7816. DOI: 10.1007/s00330-020-07632-9.
[9]
Yang E, Huang S, Ran X, et al. The 5-year overall survival of cervical cancer in stage ⅢC-r was little different to stage Ⅰ and Ⅱ：a retrospective analysis from a single center[J]. BMC Cancer, 2021, 21(1): 203. DOI: 10.1186/s12885-021-07890-w.
[10]
秦维昌. 医学影像技术的现状与发展[J]. 中华放射学杂志，2007, 41(2): 113-114. DOI: 10.3760/j.issn:1005-1201.2007.02.001.
[11]
Zhang W, Chen C, Liu P, et al. Impact of pelvic MRI in routine clinical practice on staging of ⅠB1-ⅡA2 cervical cancer[J]. Cancer Manag Res, 2019, 11: 3603-3609. DOI: 10.2147/CMAR.S197496.
[12]
Kraljević Z, Visković K, Ledinsky M, et al. Primary uterine cervical cancer: correlation of preoperative magnetic resonance imaging and clinical staging (FIGO) with histopathology findings[J]. Coll Antropol, 2013, 37(2): 561-568.
[13]
Matsumoto YK, Kido A, Moribata Y, et al. Diagnostic accuracy of magnetic resonance imaging for International Federation of Gynecology and Obstetrics 2018 ⅠB to ⅡB Cervical Cancer Staging: comparison among magnetic resonance sequences and pathologies[J]. J Comput Assist Tomogr, 2021, 45(6): 829-836. DOI: 10.1097/RCT.0000000000001210.
[14]
Patel-Lippmann K, Robbins JB, Barroilhet L, et al. MR Imaging of cervical cancer[J]. Magn Reson Imaging Clin N Am, 2017, 25(3): 635-649. DOI: 10.1016/j.mric.2017.03.007.
[15]
张婷，刘爱连，汪禾青，等. MRI动态增强扫描对宫颈癌的诊断价值[J]. 中华放射学杂志，2009, 43(9): 973-977. DOI: 10.3760/cma.j.issn.1005-1201.2009.09.019.
[16]
Fournier LS, Bats AS, Durdux C. Diffusion MRI: technical principles and application to uterine cervical cancer[J]. Cancer Radiother, 2020, 24(5): 368-373. DOI: 10.1016/j.canrad.2020.02.008.
[17]
Liu L, Wang S, Yu T, et al. Value of diffusion-weighted imaging in preoperative evaluation and prediction of postoperative supplementary therapy for patients with cervical cancer[J]. Ann Transl Med, 2022, 10(2): 120. DOI: 10.21037/atm-21-5319.
[18]
Xiao M, Yan B, Li Y, et al. Diagnostic performance of MR imaging in evaluating prognostic factors in patients with cervical cancer: a Meta-analysis[J]. Eur Radiol, 2020, 30(3): 1405-1418. DOI: 10.1007/s00330-019-06461-9.
[19]
Song Q, Yu Y, Zhang X, et al. Value of MRI and diffusion-weighted imaging in diagnosing normal-sized pelvic lymph nodes metastases in patients with cervical cancer[J]. Br J Radiol, 2022, 95(1138): 20200203. DOI: 10.1259/bjr.20200203.
[20]
Takeuchi M, Matsuzaki K, Bando Y, et al. Reduced field-of-view diffusion-weighted MR imaging for assessing the local extent of uterine cervical cancer[J]. Acta Radiol, 2020, 61(2): 267-275. DOI: 10.1177/0284185119852733.
[21]
Takeuchi M, Matsuzaki K, Harada M. The feasibility of reduced field-of-view diffusion-weighted imaging in evaluating bladder invasion of uterine cervical cancer[J]. Br J Radiol, 2022, 95(1129): 20210692. DOI: 10.1259/bjr.20210692.
[22]
Boss MK, Muradyan N, Thrall DE. DCE-MRI: a review and applications in veterinary oncology[J]. Vet Comp Oncol, 2013, 11(2): 87-100. DOI: 10.1111/j.1476-5829.2011.00305.x.
[23]
Bhardwaj R, Boruah DK, Gogoi BB, et al. Added-value of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE-MRI) magnetic resonance imaging in the preoperative assessment of cervical cancer[J]. J Obstet Gynaecol India, 2022, 72(4): 330-340. DOI: 10.1007/s13224-021-01488-9.
[24]
Song J, Hu Q, Ma Z, et al. Value of diffusion-weighted and dynamic contrast-enhanced MR in predicting parametrial invasion in cervical stromal ring focally disrupted stage ⅠB-ⅡA cervical cancers[J]. Abdom Radiol (NY), 2019, 44(9): 3166-3174. DOI: 10.1007/s00261-019-02107-y.
[25]
Kim SH, Cho SH. Assessment of pelvic lymph node metastasis in FIGO IB and ⅡA cervical cancer using quantitative dynamic contrast-enhanced MRI parameters[J]. Diagn Interv Radiol, 2020, 26(5): 382-389. DOI: 10.5152/dir.2020.19365.
[26]
Bai Z, Shi J, Yang Z, et al. Quantitative kinetic parameters of primary tumor can be used to predict pelvic lymph node metastasis in early-stage cervical cancer[J]. Abdom Radiol (NY), 2021, 46(3): 1129-1136. DOI: 10.1007/s00261-020-02762-6.
[27]
Zhang X, Dong Y, Song Q, et al. The role of multiparametric magnetic resonance imaging in the study of primary tumor and pelvic lymph node metastasis in stage ⅠB1-ⅡA1 cervical cancer[J]. J Comput Assist Tomogr, 2020, 44(5): 750-758. DOI: 10.1097/RCT.0000000000001084.
[28]
Tian Y, Luo H. Diagnostic accuracy of transvaginal ultrasound examination for local staging of cervical cancer: a systematic review and meta-analysis[J]. Med Ultrason, 2022, 24(3): 348-355. DOI: 10.11152/mu-3246.
[29]
Zhu Y, Lu M, Dai KJ, et al. Comparison between 360 degrees 3-D transvaginal ultrasound and magnetic resonance imaging for assessment of vaginal invasion in cervical cancer: a preliminary report[J]. Ultrasound Med Biol, 2021, 47(8): 2250-2257. DOI: 10.1016/j.ultrasmedbio.2021.04.013.
[30]
Zhang HP, Bai M, Gu JY, et al. Value of contrast-enhanced ultrasound in the differential diagnosis of gallbladder lesion[J]. World J Gastroenterol, 2018, 24(6): 744-751. DOI: 10.3748/wjg.v24.i6.744.
[31]
Zheng W, Chen K, Peng C, et al. Contrast-enhanced ultrasonography vs MRI for evaluation of local invasion by cervical cancer[J]. Br J Radiol, 2018, 91(1091): 20170858. DOI: 10.1259/bjr.20170858.
[32]
Shao J, Shi G, Qi Z, et al. Advancements in the application of ultrasound elastography in the cervix[J]. Ultrasound Med Biol, 2021, 47(8): 2048-2063. DOI: 10.1016/j.ultrasmedbio.2021.04.009.
[33]
Zhang Y, Yan Y, Yang Y. Study on value of ultrasonic elastography in diagnosis of clinical staging of cervical cancer and efficacy evaluation of radiotherapy[J]. Oncol Lett, 2019, 17(6): 4901-4906. DOI: 10.3892/ol.2019.10190.
[34]
Farrokh A, Treu L, Ohlinger R, et al. A orospective two center study comparing breast cancer lesion size defined by 2D shear wave elastography, B-mode ultrasound, and mammography with the histopathological size[J]. Ultraschall Med, 2019, 40(2): 212-220. DOI: 10.1055/a-0661-5952.
[35]
Fu B, Zhang H, Song ZW, et al. Value of shear wave elastography in the diagnosis and evaluation of cervical cancer[J]. Oncol Lett, 2020, 20(3): 2232-2238. DOI: 10.3892/ol.2020.11759.
[36]
于甬华，于金明. 正电子发射型计算机断层显像在肿瘤临床中的应用[J]. 中华肿瘤杂志，2003, 25(6): 615-617.
[37]
Yang Z, Xu W, Ma Y, et al. (18)F-FDG PET/CT can correct the clinical stages and predict pathological parameters before operation in cervical cancer[J]. Eur J Radiol, 2016, 85(5): 877-884. DOI: 10.1016/j.ejrad.2016.02.010.
[38]
Martinez A, Voglimacci M, Lusque A, et al. Tumour and pelvic lymph node metabolic activity on FDG-PET/CT to stratify patients for para-aortic surgical staging in locally advanced cervical cancer[J]. Eur J Nucl Med Mol Imaging, 2020, 47(5): 1252-1260. DOI: 10.1007/s00259-019-04659-z.
[39]
Tsuyoshi H, Tsujikawa T, Yamada S, et al. Diagnostic value of 18F-FDG PET/MRI for revised 2018 FIGO staging in patients with cervical cancer[J]. Diagnostics (Basel), 2021, 11(2): 202. DOI: 10.3390/diagnostics11020202.
[40]
Weissinger M, Taran FA, Gatidis S, et al. Lymph node staging with a combined protocol of 18F-FDG PET/MRI and sentinel node SPECT/CT: a prospective study in patients with FIGO Ⅰ/Ⅱ cervical carcinoma[J]. J Nucl Med, 2021, 62(8): 1062-1067. DOI: 10.2967/jnumed.120.255919.
[41]
雒海瑕，王伟，郝敏. 基因拷贝数变异在宫颈癌的研究现状[J/OL]. 中华妇幼临床医学杂志(电子版), 2022, 18(2) : 139-144. DOI: 10.3877/cma.j.issn.1673-5250.2022.02.003.
[1] 魏淑婕, 惠品晶, 丁亚芳, 张白, 颜燕红, 周鹏, 黄亚波. 单侧颈内动脉闭塞患者行颞浅动脉-大脑中动脉搭桥术的脑血流动力学评估[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1046-1055.
[2] 张璇, 马宇童, 苗玉倩, 张云, 吴士文, 党晓楚, 陈颖颖, 钟兆明, 王雪娟, 胡淼, 孙岩峰, 马秀珠, 吕发勤, 寇海燕. 超声对Duchenne肌营养不良儿童膈肌功能的评价[J]. 中华医学超声杂志（电子版）, 2023, 20(10): 1068-1073.
[3] 朱连华, 费翔, 韩鹏, 姜波, 李楠, 罗渝昆. 高帧频超声造影在胆囊息肉样病变中的鉴别诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 904-910.
[4] 丁建民, 秦正义, 张翔, 周燕, 周洪雨, 王彦冬, 经翔. 超声造影与普美显磁共振成像对具有高危因素的≤3 cm肝结节进行LI-RADS分类诊断的前瞻性研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 930-938.
[5] 张梅芳, 谭莹, 朱巧珍, 温昕, 袁鹰, 秦越, 郭洪波, 侯伶秀, 黄文兰, 彭桂艳, 李胜利. 早孕期胎儿头臀长正中矢状切面超声图像的人工智能质控研究[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 945-950.
[6] 陈舜, 薛恩生, 叶琴. PDCA在持续改进超声危急值管理制度中的价值[J]. 中华医学超声杂志（电子版）, 2023, 20(09): 974-978.
[7] 周钰菡, 肖欢, 唐毅, 杨春江, 周娟, 朱丽容, 徐娟, 牟芳婷. 超声对儿童髋关节暂时性滑膜炎的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 795-800.
[8] 刘欢颜, 华扬, 贾凌云, 赵新宇, 刘蓓蓓. 颈内动脉闭塞病变管腔结构和血流动力学特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 809-815.
[9] 张莲莲, 惠品晶, 丁亚芳. 颈部血管超声在粥样硬化斑块易损性评估中的应用价值[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 816-821.
[10] 郏亚平, 曾书娥. 含鳞状细胞癌成分的乳腺化生性癌的超声与病理特征分析[J]. 中华医学超声杂志（电子版）, 2023, 20(08): 844-848.
[11] 张丽丽, 陈莉, 余美琴, 聂小艳, 王婧玲, 刘婷. PDCA循环法在超声浅表器官亚专科建设中的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(07): 717-721.
[12] 罗刚, 泮思林, 陈涛涛, 许茜, 纪志娴, 王思宝, 孙玲玉. 超声心动图在胎儿心脏介入治疗室间隔完整的肺动脉闭锁中的应用[J]. 中华医学超声杂志（电子版）, 2023, 20(06): 605-609.
[13] 黄佳, 石华, 张玉国, 胡佳琪, 陈茜. 胎儿左头臂静脉正常与异常超声图像特征及其临床意义[J]. 中华医学超声杂志（电子版）, 2023, 20(06): 610-617.
[14] 袁泽, 庄丽. 超声检测胎儿脐动脉和大脑中动脉血流对胎儿宫内窘迫的诊断价值[J]. 中华医学超声杂志（电子版）, 2023, 20(06): 618-621.
[15] 孔博, 张璟, 吕珂. 超声技术在复杂腹壁疝诊治中的作用[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 670-673.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号