A study on the clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography combined with serum squamous cell carcinoma antigen in diagnosing recurrence/metastases in patients with early metaphase cervical cancer

Abstract

Cervical cancer (CC) is the most common female genital tract malignancy, with repercussions on the psychophysiological health of female patients. Patients with CC are faced with a high risk of postoperative recurrence and metastases. The present study aimed to evaluate the clinical value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) combined with serum squamous cell carcinoma antigen (SCC-Ag) in the diagnosis of postoperative recurrence/metastases in patients with early stage CC. This was a prospective follow-up study on 246 patients who received surgery for early stage CC. The results of clinical follow-up and pathological examination were taken as the gold standard. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic (ROC) curve were calculated for PET/CT, serum SCC-Ag determination and the combined PET/CT and serum SCC-Ag method. Results demonstrated that 90.11% patients completed the follow-up, and the median follow-up time was 22 months (range, 7–42 months). Tumor recurrence or metastasis was confirmed in a total of 137 patients (55.7%), including 18 deaths. The diagnostic sensitivity of PET/CT scan combined with serum SCC-Ag determination for postoperative metastases/recurrence in patients with early stage CC was 93.43% (95% CI, 0.875–0.967). The specificity was 92.67% (95% CI, 0.856–0.965), the positive predictive value was 94.12% (95% CI, 0.884–0.972), the negative predictive value was 91.81% (95% CI, 0.846–0.959) and the area under the ROC curve was 0.930±0.019 (95% CI, 0.893–0.968; P<0.001). The results also revealed that the serum SCC-Ag level was positively correlated with SUVmax (r=0.458; P<0.001). The results from the present study demonstrated that for patients with early metaphase CC, PET/CT scan combined with serum SCC-Ag determination during the follow-up was capable of earlier, more comprehensive and more accurate detection of recurrence/metastatic lesions, which is of high clinical application value.