Correlation of ¹⁸F-FDG PET/CT metabolic parameter, inflammatory indexes and SCC-Ag with clinical staging and pathological features of locally progressive cervical squamous carcinoma

Objective To investigate the correlation of ¹⁸F-FDG PET/CT metabolic parameters, inflammatory indexes and SCC-Ag with FIGO clinical stage and pathological characteristics in locally advanced cervical squamous carcinoma, so as to provide reference for the evaluation of pathological features and accurate clinical staging of cervical squamous carcinoma.

Methods Retrospective analysis of ¹⁸F-FDG PET/CT images, serum tumor markers and inflammatory indicators of patients with cervical squamous carcinoma treated in Qingdao Central Hospital from August 2015 to October 2023, with a total of 56 patients, aged (56.0±9.2) years. Fifty-six patients with stage ⅡB-ⅣA cervical squamous carcinoma diagnosed by pathology were examined by ¹⁸F-FDG PET/CT and serological examination to obtain parameters such as SUVmax, SUVmean, MTV, TLG, nSUVmax, SCC-Ag and inflammatory indexes. The Spearman rank correlation analysis was used to analyze the correlation between ¹⁸F-FDG metabolic parameters, serum tumor markers, inflammatory markers and clinicopathological features of cervical squamous carcinoma (stage ⅡB-ⅣA).

Results Of the 56 patients, 13(23.21%) were stage ⅡB, 34(60.72%) were stage Ⅲ, and 9(16.07%) were stage ⅣA. Thirty-eight (67.86%) of the patients had lymph node metastasis at the initial staging. Some ¹⁸F-FDG PET/CT metabolic parameters, such as nSUVmax, MTV, TLG, T/L, and N/L were positively correlated with FIGO staging(r=0.317~0.431, all P<0.05), inflammation indicators NLR and PLR were positively correlated with FIGO staging (r=0.311、0.285, all P<0.05), and LMR and ALB were negatively correlated with FIGO staging (r=−0.481、−0.547, all P<0.05). All of the ¹⁸F-FDG PET/CT metabolic parameters were positively correlated with lymph node metastasis (r=0.300~0.823, all P<0.05), and ALB was negatively correlated with lymph node metastasis (r=−0.303, P<0.05). SCC-Ag was positively correlated with FIGO stage and lymph node metastasis in cervical squamous cancer (r=0.515、0.433, all P<0.05). ¹⁸F-FDG PET/CT metabolic parameters, inflammatory indexes and SCC-Ag were not statistically significant correlated with pathologic grade (r=−0.083~0.141, all P>0.05). And there was also a certain correlation between ¹⁸F-FDG PET/CT metabolic parameters, inflammatory indexes and SCC-Ag (r=−0.478~0.750).

Conclusion Metabolic parameters of primary foci of cervical cancer, inflammatory indexes and serum tumor markers have different degrees of correlation with clinicopathological features and FIGO grading, which can reflect the biological and pathological characteristics of tumors in patients with cervical cancer, and are conducive to the evaluation of pathological features and accurate clinical staging of squamous carcinoma of the uterine cervix.