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目的:探讨术前n 18F-脱氧葡萄糖(FDG) PET/CT参数联合凝血参数预测早期宫颈癌患者术后复发的价值。n 方法:回顾性收集中国医科大学附属盛京医院2012年1月至2014年12月间术前进行n 18F-FDG PET/CT检查、凝血指标检测，术后经过系统随访的宫颈癌患者120例[年龄25～70(47.9±8.5)岁]。根据术后是否复发，将患者分为复发组及非复发组，使用两样本n t检验或Mann-Whitney n U检验比较组间PET/CT显像参数和术前凝血参数的差异；进行各参数的受试者工作特征(ROC)曲线分析；使用单因素、多因素Cox比例风险模型分析各参数对于术后复发的预测价值。n 结果:随访时间(2～60)个月，复发病例36例，占30.0%(36/120)。中分化组(n n＝89)的复发(n n＝27)和未复发(n n＝62)患者之间平均标准摄取值(SUVn mean)、标准摄取峰值(SUVn peak)、病灶糖酵解总量(TLG)差异有统计学意义[8.90±3.00和7.50±2.90，12.00±3.70和10.20±4.50，144.48(43.79，366.46)和60.23(28.46，113.15)g；n t值：1.968、2.063，n U＝547.000，均n P<0.05]；低分化组(n n＝19)的复发(n n＝7)和未复发(n n＝12)患者除上述指标外，最大标准摄取值(SUVn max)差异也有统计学意义[16.10±4.70和7.60±2.33，8.70±2.10和4.40±1.50，13.30±4.40和5.60±1.80，140.37(131.44，143.94)和31.64(15.84，92.14) g；n t值：5.363、4.829、5.429，n U＝3.000，均n P<0.05]；复发与未复发患者的D-二聚体及纤维蛋白原(FIB)差异有统计学意义[175.00(100.00，256.00)和86.00(51.25，115.25) mg/L，(3.10±0.50)和(2.80±0.50) mg/L；n U＝619.500，n t＝2.962，均n P<0.05]。ROC曲线示SUVn max[曲线下面积(AUC)＝0.651]、SUVn mean(AUC＝0.650)、SUVn peak(AUC＝0.675)、TLG(AUC＝0.703)以及D-二聚体(AUC＝0.795)、FIB(AUC＝0.672)等因素可以预测疾病的复发(均n P<0.01)。Cox单因素分析显示宫颈癌国际妇产科联盟(FIGO)分期[风险比(n HR)＝2.363(95% n CI：1.217～4.590)]、SUVn max[n HR＝4.855(95% n CI：1.488～15.841)]、SUVn mean[n HR＝4.451(95% n CI：1.573～12.597)]、SUVn peak[n HR＝7.190(95% n CI：2.203～23.469)]、TLG[n HR＝4.396(95% n CI：2.238～8.633)]、D-二聚体[n HR＝4.761(95% n CI：2.470～9.253]及FIB[n HR＝3.196(95% n CI：1.596～6.400)]是预测早期宫颈癌术后复发的危险因素(均n P<0.05)；多因素分析显示D-二聚体[n HR＝2.974(95% n CI：1.476～5.990)]及SUVn peak[n HR＝3.826(95% n CI：1.063～13.778)]是主要预测因素(均n P<0.05)。ROC曲线示SUVn peak和D-二聚体联合预测复发的AUC为0.841(n P<0.01)。n 结论:SUVn peak和D-二聚体是预测宫颈癌手术治疗患者术后复发的主要指标，两者联合预测价值良好。n “,”Objective:To explore the value of preoperative n 18F-fluorodeoxyglucose(FDG) PET/CT parameters combined with coagulation parameters in predicting the recurrence after surgery in patients with early cervical cancer.n Methods:A total of 120 patients(age range: 25-70 (47.9±8.5) years) with cervical cancer who underwent preoperative n 18F-FDG PET/CT examination and blood coagulation index test in Shengjing Hospital of China Medical University between January 2012 and December 2014 were retrospectively analyzed. Patients were divided into recurrent group and non-recurrent group according to the follow-up results. Independent-sample n t test or Mann-Whitney n U test was used to compare the differences of related parameters between the recurrent and non-recurrent patients. Then the receiver operating characteristic (ROC) curve analysis was performed, and univariate and multivariate Cox analyses were used to evaluate the predictive value of parameters.n Results:The follow-up time was 2-60 months. There were 36 recurrent cases, accounting for 30.0% (36/120) of all patients. The mean standardized uptake value (SUVn mean), peak of standardized uptake value (SUVn peak) and total lesion glycosis (TLG) were significantly different between recurrent (n n=27) and non-recurrent (n n=62) subgroups of moderately differentiated patiens (8.90±3.00 n vs 7.50±2.90, 12.00±3.70 n vs 10.20±4.50, 144.48(43.79, 366.46) n vs 60.23(28.46, 113.15) g; n t values: 1.968, 2.063, n U=547.000, all n P<0.05); the maximum standardized uptake value (SUVn max), SUVn mean, SUVn peak, TLG were significantly different between recurrent (n n=7) and non-recurrent (n n=12) subgroups of poorly differentiated patiens (16.10±4.70 n vs 7.60±2.33, 8.70±2.10 n vs 4.40±1.50, 13.30±4.40 n vs 5.60±1.80, 140.37(131.44, 143.94) n vs 31.64(15.84, 92.14) g; n t values: 5.363, 4.829, 5.429, n U=3.000, all n P<0.05); D-dimer and fibrinogen (FIB) of recurrent and non-recurrent patients were also different (175.00(100.00, 256.00)n vs 86.00(51.25, 115.25) mg/L, (3.10±0.50) n vs (2.80±0.50) mg/L; n U=619.500, n t=2.962, both n P<0.05). The ROC curve indicated that SUVn max (area under curve (AUC)=0.651), SUVn mean (AUC=0.650), SUVn peak (AUC=0.675), TLG (AUC=0.703), D-dimer (AUC=0.795) and FIB (AUC=0.672) could predict the recurrence of the disease(all n P<0.01). Univariate Cox analysis revealed that the International Federation of Gynecology and Obstetrics (FIGO) staging (hazard ratio (n HR)=2.363, 95% n CI: 1.217-4.590), SUVn max (n HR=4.855, 95% n CI: 1.488-15.841), SUVn mean (n HR=4.451, 95% n CI: 1.573-12.597), SUVn peak (n HR=7.190, 95% n CI: 2.203-23.469), TLG (n HR=4.396, 95% n CI: 2.238-8.633), D-dimer (n HR=4.761, 95% n CI: 2.470-9.253) and FIB (n HR=3.196, 95% n CI: 1.596-6.400) were predictive factors of recurrence (all n P<0.05). Multivariate Cox analysis showed that D-dimer (n HR=2.974, 95% n CI: 1.476-5.990) and SUVn peak (n HR=3.826, 95% n CI: 1.063-13.778) were the main predictors (both n P<0.05). ROC curve of SUVn peak combined with D-dimer showed the AUC of 0.841(n P<0.01).n Conclusions:SUVn peak and D-dimer are main indexes to evaluate the recurrence after surgery in patients with cervical cancer. SUVn peak combined with D-dimer have good predictive value for the recurrence of cervical cancer.n