目的：分析病灶¹⁸F-脱氧葡萄糖最大标准摄取值（¹⁸F-FDG-SUV_max）和血清细胞角蛋白19的可溶性片段（CYFRA21-1）水平与ⅡB~ⅣB期宫颈鳞癌患者生存预后的关系。方法：回顾性分析2013年10月至2016年10月入东南大学附属中大医院溧水分院和江苏省肿瘤医院确诊宫颈鳞癌患者共100例，接受同步放化疗，随访中位时间61.0个月。采用受试者工作特征（ROC）曲线获得治疗前¹⁸F-FDG-SUV_max和CYFRA21-1预测总生存期（OS）的效能和最佳临界值，比较组间患者的临床病理特征和OS，单因素和多因素Cox比例风险模型筛选OS的危险因素。结果：¹⁸F-FDG-SUV_max和CYFRA21-1的最佳临界值分别为14.5和22.9 ng·ml^-1，曲线下面积（AUC）分别为0.844和0.813（P<0.05）。与¹⁸F-FDG-SUV_max<14.5患者相比，¹⁸F-FDG-SUV_max≥14.5患者绝经、ⅢA~ⅣB期、局部淋巴结和远处转移增多，OS降低（均P<0.05）；与CYFRA21-1<22.9 ng·ml^-1患者相比，CYFRA21-1≥22.9 ng·ml^-1患者绝经、ⅢA~ⅣB期、局部淋巴结和远处转移增多，OS降低（P<0.05）。多因素分析显示，ⅢA~ⅣB期、远处转移、¹⁸F-FDG-SUV_max≥14.5和CYFRA21-1≥22.9 ng·ml^-1是宫颈鳞癌患者生存的独立危险因素（P<0.05）。结论：病灶¹⁸F-FDG-SUV_max和血清CYFRA21-1水平与ⅡB~ⅣB期宫颈鳞癌患者生存预后密切相关，可能成为晚期宫颈鳞癌的标志物。

[1] BRAY F, FERLAY J, SOERJOMATARAM I, et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin, 2018, 68(6):394-424.
[2] HU K, WANG W, LIU X, et al.Comparison of treatment outcomes between squamous cell carcinoma and adenocarcinoma of cervix after definitive radiotherapy or concurrent chemoradiotherapy[J].Radiat Oncol, 2018, 13(1):249.
[3] WANG W, ZHANG F, HU K, et al.Image-guided, intensity-modulated radiation therapy in definitive radiotherapy for 1433 patients with cervical cancer[J].Gynecol Oncol, 2018, 151(3):444-448.
[4] 张芳, 吕蓓丽, 赵于天, 等.新辅助化疗后胸腔镜手术对Ⅲa-N₂期NSCLC患者血清CYFRA21-1、NSE的影响[J].现代医学, 2018, 46(9):1009-1014.
[5] 梁铮, 鲍永霞, 苏冬菊, 等.细胞角蛋白19片段的临床应用[J].现代医学, 2016, 44(5):755-758.
[6] CHONG G O, LEE W K, JEONG S Y, et al.Prognostic value of intratumoral metabolic heterogeneity on F-18 fluorodeoxyglucose positron emission tomography/computed tomography in locally advanced cervical cancer patients treated with concurrent chemoradiotherapy[J].Oncotarget, 2017, 8(52):90402-90412.
[7] SOOKHA R R, ZHI W, SHEN Y, et al.Clinical value of combining 18F-FDG PET/CT and routine serum tumor markers in the early detection of recurrence among follow-up patients treated for cervical squamous cell carcinoma[J].J Cancer, 2018, 9(17):3101-3108.
[8] JUNG W, PARK K R, LEE K J, et al.Value of imaging study in predicting pelvic lymph node metastases of uterine cervical cancer[J].Radiat Oncol J, 2017, 35(4):340-348.
[9] 李静, 索红燕, 孔为民.《国际妇产科联盟(FIGO)2018癌症报告:宫颈癌新分期及诊治指南》解读[J].中国临床医生杂志, 2019, 47(6):646-649.
[10] FLOBERG J M, ZHANG J, DE WEES T A, et al.Pre-treatment[F-18] FDG-PET SUVmax as a prognostic and radiogenomic marker in cervical cancer[J].Int J Radiat Oncol Biol Phys, 2018, 102(3):S82-S83.
[11] 王祖飞, 兰茜琳, 肖扬锐, 等.原发性胆管癌TNM分期与~(18)F-脱氧葡萄糖正电子发射计算机断层扫描最大标准摄取值的相关性[J].中华医学杂志, 2017, 97(39):3104-3107.
[12] KIM Y J, HAN S, KIM Y S, et al.Prognostic value of post-treatment ¹⁸F-fluorodeoxyglucose positron emission tomography in uterine cervical cancer patients treated with radiotherapy:a systematic review and meta-analysis[J].J Gynecol Oncol, 2019, 30(5):e66.
[13] 赵红霞, 董艳双, 蔡友治, 等.¹⁸F-氟脱氧葡萄糖的最大标准摄取值评估宫颈癌伴淋巴结转移患者预后的价值[J].中国全科医学, 2017, 20(6):668-672.
[14] LAWAL I O, OLOLADE K O, POPOOLA G O, et al.¹⁸F-FDG-PET/CT imaging of uterine cervical cancer recurrence in women with and without HIV infection[J].Q J Nucl Med Mol Imaging, 2019, 3(4):1546-1547.
[15] CEGLA P, URBANSKI B, BURCHARDT E, et al.Influence of ¹⁸F-FDG-PET/CT on staging of cervical cancer[J].Nuklearmedizin, 2019, 58(1):17-22.
[16] BRITO A E T, MATUSHITA C, ESTEVES F, et al.Cervical cancer-staging and restaging with ¹⁸F-FDG PET/CT[J].Rev Assoc Med Bras, 2019, 65(4):568-575.
[17] 苏玥辉, 张梦真.血清CYFRA21-1、TSGF、OPN在宫颈癌晚期中的表达及意义[J].实用癌症杂志, 2020, 35(8):1278-1280.
[18] 阿衣西布卫·库尔班, 战英杰, 王景, 等.细胞角质蛋白19片段抗原21-1、鳞状细胞癌抗原和糖类抗原153联合检测对宫颈癌的诊断价值[J].癌症进展, 2020, 18(11):1167-1170.
[19] 王飞霞, 杨瑞利, 韩双.细胞DNA定量分析联合HR-HPV、SCCA、CYFRA21-1检测在早期宫颈癌筛查中的价值[J].肿瘤学杂志, 2018, 24(3):281-284.
[20] 王建东, 孔为民, 姜昊.国际妇产科联盟2018年宫颈癌分期及有关问题[J].中华肿瘤杂志, 2020, 42(2):94-98.
[21] CAVALCANTE I P, ZERBINI M C, ALENCAR G A, et al.High ¹⁸F-FDG uptake in PMAH correlated with normal expression of Glut1, HK1, HK2, and HK3[J].Acta Radiol, 2016, 57(3):370-377.
[22] LERAY H, GABIACHE E, COURBON F, et al.¹⁸F-FDG PET/CT identifies predictors of survival in patients with locally advanced cervical carcinoma and paraaortic lymph node involvement to allow intensification of treatment[J].J Nucl Med, 2020, 61(10):1442-1447.
[23] RAYCHAUDHURI S, ABRIA C, HARMANY Z T, et al.Quantitative tracking of inflammatory activity at the peak and trough plasma levels of tofacitinib, a Janus kinase inhibitor, via in vivo (18) F-FDG PET[J].Int J Rheum Dis, 2019, 22(12):2165-2169.