Volume 21 Issue 2
Feb.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(2): 199-202
ZHAO Meng-qiu, JIN Mao-sheng, LIU Hong-li, LIU Jian. Prediction of lymph node metastasis in early cervical cancer by MRI combined with preoperative serological indices and pathological features[J]. Chinese Journal of General Practice, 2023, 21(2): 199-202. doi: 10.16766/j.cnki.issn.1674-4152.002844
Citation: ZHAO Meng-qiu, JIN Mao-sheng, LIU Hong-li, LIU Jian. Prediction of lymph node metastasis in early cervical cancer by MRI combined with preoperative serological indices and pathological features[J]. Chinese Journal of General Practice, 2023, 21(2): 199-202. doi: 10.16766/j.cnki.issn.1674-4152.002844
shu

Prediction of lymph node metastasis in early cervical cancer by MRI combined with preoperative serological indices and pathological features

doi: 10.16766/j.cnki.issn.1674-4152.002844
  • 1.

    Department of Obstetrics and Gynecology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

Funds:

 KJ2019A0346

  • Received Date: 2022-05-17
    Available Online: 2023-04-20
    Abstract
  •   Objective  This study aims to investigate the predictive value of MRI combined with preoperative serological markers: squamous cell carcinoma antigen (SCC-Ag), neutrophil to lymphocyte ratio (NLR) and biopsy pathology in lymph node metastasis of early cervical cancer.  Methods  A total of 307 patients who underwent primary surgery in the First Affiliated Hospital of Bengbu Medical College from January 2019 to February 2022 were selected and divided into lymph node metastasis group (81 cases) and no lymph node metastasis group (226 cases) according to the presence or absence of lymph node metastasis after surgery. The MRI lymph node short diameter, tumour size, interstitial infiltration depth, parauterine and vaginal involvement, preoperative serological indices and pathological features of the 2 groups were compared. The predictive value of lymph node metastasis and the significance of combined diagnosis were analysed.  Results  Logistic regression analysis showed that large short diameter of MRI lymph nodes, large tumor diameter, depth of interstitial infiltration greater than 1/2 muscular layer, parametrial involvement, increased expression of SCC-Ag and positive vascular were independent risk factors for lymph node metastasis of cervical cancer (P < 0.05). The areas under the ROC curve of MRI lymph node diameter, SCC-Ag and NLR for the diagnosis of cervical cancer LNM were 0.806, 0.711 and 0.630, respectively. The optimal cut-off values were 8.50 mm, 2.55 ng/mL and 1.90, respectively. The sensitivity values were 0.654, 0.593 and 0.593, respectively, and the specificity values were 0.881, 0.757 and 0.642, respectively. The area under the ROC curve of MRI lymph node short diameter combined with SCC-Ag diagnosis was 0.846. The area under ROC curve for the combined diagnosis of MRI lymph node short diameter, SCC-Ag and NLR was 0.863. The area under ROC curve of multiple indicators (SCC-Ag, MRI lymph node short diameter, tumour size, interstitial infiltration depth, parauterine involvement, and vascular positive) for combined diagnosis of cervical cancer LNM was 0.926.  Conclusion  Imaging examination (MRI) combined with serological indicators and clinicopathological features can improve the predictive value of cervical cancer lymph node metastasis.

     

    • FullText(HTML)
  • loading
    • References(23)
  • [1]
    张军. 宫颈癌治疗的现状及问题: 从临床指南到真实世界研究[J]. 中国全科医学, 2022, 25(3): 259-263. doi: 10.12114/j.issn.1007-9572.2021.02.105

    ZHANG J. Current status and challenges of cervical cancer treatment: from clinical guidelines to real-world study[J]. Chinese General Practice, 2022, 25(3): 259-263. doi: 10.12114/j.issn.1007-9572.2021.02.105
    [2]
    陈一蕊, 勾朝阳, 李新阳. 血清SCC-Ag、sE-cadherin、β-HCG在宫颈癌诊断中的应用价值[J]. 实用癌症杂志, 2022, 37(3): 376-379. doi: 10.3969/j.issn.1001-5930.2022.03.007

    CHEN Y R, GOU C Y, LI X Y. Value of Serum SCC-Ag, sE-cadherin and β-HCG in the diagnosis of cervical cancer[J]. The Practical Journal of Cancer, 2022, 37(3): 376-379. doi: 10.3969/j.issn.1001-5930.2022.03.007
    [3]
    胡玉峰, 程晓东. NLR、FAR、SCC-Ag对宫颈鳞状细胞癌患者术前淋巴结转移的预测价值[J]. 中国妇产科临床杂志, 2022, 23(3): 278-280. https://www.cnki.com.cn/Article/CJFDTOTAL-FKLC202203018.htm

    HU Y F, CHENG X D. Predictive value of NLR, FAR and SCC-Ag in preoperative lymph node metastasis of patients with cervical squamous cell carcinoma[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2022, 23(3): 278-280. https://www.cnki.com.cn/Article/CJFDTOTAL-FKLC202203018.htm
    [4]
    MASRI A, STEINMETZ L, ROBINSON W R. Women with cervical carcinoma in pre-and post-katrina new orleans: a comparative analysis[J]. Gynecol Oncol, 2020, 156(3): 31-32.
    [5]
    周琦, 吴小华, 刘继红, 等. 宫颈癌诊断与治疗指南(第四版)[J]. 中国实用妇科与产科杂志, 2018, 34(6): 613-622. doi: 10.19538/j.fk2018060111

    ZHOU Q, WU X H, LIU J H, et al. Guidelines to the diagnosis and treatment of cervical cancer (4th edition)[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2018, 34(6): 613-622. doi: 10.19538/j.fk2018060111
    [6]
    COHEN P A, JHINGRAN A, OAKNIN A, et al. Cervical cancer[J]. Lancet, 2019, 393(10167): 169-182. doi: 10.1016/S0140-6736(18)32470-X
    [7]
    KAN Y Y, DONG D, ZHANG Y C, et al. Radiomic signature as a predictive factor for lymph node metastasis in early-stage cervical cancer[J]. J Magn Reson Imaging, 2019, 49(1): 304-310. doi: 10.1002/jmri.26209
    [8]
    周晖, 刘昀昀, 罗铭, 等. 《2021 NCCN子宫颈癌临床实践指南(第1版)》解读[J]. 中国实用妇科与产科杂志, 2020, 36(11): 1098-1104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202011015.htm

    ZHOU H, LIU Y Y, LUO M, et al. Interpretation of the NCCN clinical practice guidelines for cervical cancer(2021. v1)[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2020, 36(11): 1098-1104. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202011015.htm
    [9]
    洪士彬, 程杰军, 狄文. MRI在宫颈癌分期评估中的临床应用及研究进展[J]. 国际妇产科学杂志, 2021, 48(6): 634-638. https://www.cnki.com.cn/Article/CJFDTOTAL-GWVC202106008.htm

    HONG S B, CHENG J J, DI W. Advances and applications of MRI in Staging assessment of cervical cancer[J]. Journal of International Obstetrics and Gynecology, 2021, 48(6): 634-638. https://www.cnki.com.cn/Article/CJFDTOTAL-GWVC202106008.htm
    [10]
    TOMASSI M J, ABBAS M A, KLARISTENFELD D D. Expectant management surveillance for patients at risk for invasive squamous cell carcinoma of the anus: a large US health care system experience[J]. Int J Colorectal Dis, 2019, 34(1): 47-54. doi: 10.1007/s00384-018-3167-7
    [11]
    马梅, 晋茂生, 叶国柳. HPV分型、SCC-Ag与NLR联合对早期宫颈癌淋巴结转移的预测作用[J]. 中华全科医学, 2022, 20(4): 578-582. doi: 10.16766/j.cnki.issn.1674-4152.002404

    MA M, JIN M S, YE G L. Predictive effect of HPV typing, SCC-Ag and NLR on lymph node metastasis of early cervical cancer[J]. Chinese Journal of General Practice, 2022, 20(4): 578-582. doi: 10.16766/j.cnki.issn.1674-4152.002404
    [12]
    LIU Z H, SHI H T. Prognostic role of squamous cell carcinoma antigen in cervical cancer: a meta-analysis[J]. Dis Markers, 2019, 2019: 6710352. DOI: 10.1155/2019/6710352.
    [13]
    李丹, 徐小仙, 闫鼎鼎, 等. 早期宫颈鳞状细胞癌患者检测血清鳞状细胞癌抗原的临床意义[J]. 中华肿瘤杂志, 2019, 41(5): 357-362. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202123018.htm

    LI D, XU X X, YAN D D, et al. Clinical significance of serum squamous cell carcinoma antigen in patients with early cervical squamous cell carcinoma[J]. Chinese Journal of Oncology, 2019, 41(5): 357-362. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202123018.htm
    [14]
    张冬雅, 郭红军. 18F-FDG PET-CT联合血清SCC-Ag检测对宫颈癌盆腔淋巴结转移的诊断价值[J]. 中国CT和MRI杂志, 2019, 17(3): 105-108, 153. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201903032.htm

    ZHANG D Y, GUO H J. Value of 18F-FDG PET-CT combined with serum SCC-Ag in diagnosing pelvic lymph node metastasis of cervical cancer[J]. Chinese Journal of CT and MRI, 2019, 17(3): 105-108, 153. https://www.cnki.com.cn/Article/CJFDTOTAL-CTMR201903032.htm
    [15]
    秦琳, 吴玉梅, 王明, 等. 增强CT淋巴结短径及SCC-Ag在术前预测宫颈鳞癌淋巴结转移中的应用[J]. 中国医药导报, 2022, 19(5): 124-128. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202205028.htm

    QIN L, WU Y M, WANG M, et al. Application of the shortest diameter of lymph nodes in enhanced CT and SCC-Ag predicting pre-operation lymph node metastasis in cervical squamous cell carcinoma[J]. China Medical Herald, 2022, 19(5): 124-128. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202205028.htm
    [16]
    张文静, 田红梅, 王冲, 等. NLR、PLR对结肠癌根治术后手术部位感染的预测价值[J]. 分子诊断与治疗杂志, 2022, 14(2): 245-248. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYQ202202016.htm

    ZHANG W J, TIAN H M, WANG C, et al. Predictive value of NLR and PLR for surgical site infection after radical resection of colon cancer[J]. Journal of Molecular Diagnostics and Therapy, 2022, 14(2): 245-248. https://www.cnki.com.cn/Article/CJFDTOTAL-YXYQ202202016.htm
    [17]
    ZHU M L, FENG M, HE F, et al. Pretreatment neutrophil-lymphocyte and platelet-lymphocyte ratio predict clinical outcome and prognosis for cervical Cancer[J]. Clin Chim Acta, 2018, 483: 296-302.
    [18]
    梅冰洁, 张国楠. 中性粒细胞、血小板与淋巴细胞比值对中晚期宫颈癌患者预后的评估价值[J]. 现代妇产科进展, 2019, 28(12): 892-895. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC201912003.htm

    MEI B J, ZHANG G N. Prognostic value of neutrophil, platelet to lymphocyte ratio in patients with advanced cervical cancer[J]. Progress in Obstetrics and Gynecology, 2019, 28(12): 892-895. https://www.cnki.com.cn/Article/CJFDTOTAL-XDFC201912003.htm
    [19]
    赵雅文, 董頔, 薛茜文, 等. 术前外周血中NLR、PLR、LMR与早期宫颈癌患者预后的相关性研究[J]. 新疆医科大学学报, 2020, 43(8): 997-1003. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY202008004.htm

    ZHAO Y W, DONG D, XUE Q W, et al. Correlation between NLR, PLR and LMR in preoperative peripheral blood and prognosis of patients with early cervical cancer[J]. Journal of Xinjiang Medical University, 2020, 43(8): 997-1003. https://www.cnki.com.cn/Article/CJFDTOTAL-XJYY202008004.htm
    [20]
    王金凤, 李琛, 黄康榕, 等. 术前中性粒细胞和淋巴细胞比值、单核细胞和淋巴细胞比值与宫颈癌患者临床病理特征的相关性[J]. 兰州大学学报(医学版), 2019, 45(5): 25-29. https://www.cnki.com.cn/Article/CJFDTOTAL-LZYX201905008.htm

    WANG J F, LI C, HUANG K R, et al. Correlation between preoperative neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio and clinical pathologic features in patients with cervical cancer[J]. 兰州大学学报(医学版), 2019, 45(5): 25-29. https://www.cnki.com.cn/Article/CJFDTOTAL-LZYX201905008.htm
    [21]
    乌云, 苏俊玲, 杜洁, 等. 宫颈癌临床病理特征与宫旁侵犯及盆腔淋巴结转移的关系研究[J]. 局解手术学杂志, 2019, 28(12): 969-972. https://www.cnki.com.cn/Article/CJFDTOTAL-JJXZ201912009.htm

    WU Y, SU J L, DU J, et al. Correlation study of clinicopathologic features with parametrial invasion and pelvic lymph node metastasis in cervical cancer patients[J]. Journal of Regional Anatomy and Operative Surgery, 2019, 28(12): 969-972. https://www.cnki.com.cn/Article/CJFDTOTAL-JJXZ201912009.htm
    [22]
    蔡斌, 吴昊, 丰有吉, 等. 100例宫颈癌临床病理特征与宫旁侵犯和盆腔淋巴结转移的关系分析[J]. 实用妇产科杂志, 2015, 31(5): 366-368. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201505019.htm

    CAI B, WU H, FENG Y J, et al. Correlation between the clinical pathology characteristic and parametrial involvement or pelvic lymph node metastasis in 100 cases of cervical cancer[J]. Journal of Practical Obstetrics and Gynecology, 2015, 31(5): 366-368. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201505019.htm
    [23]
    周晖, 王东雁, 罗铭, 等. 《FIGO 2018妇癌报告》: 子宫颈癌指南解读[J]. 中国实用妇科与产科杂志, 2019, 35(1): 95-103. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202205014.htm

    ZHOU H, WANG D Y, LUO M, et al. FIGO 2018 Women's Cancer Report: Interpretation of cervical cancer Guidelines[J]. Chinese Journal of Practical Gynecology and Obstetrics, 2019, 35(1): 95-103. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202205014.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (371) PDF downloads(14) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return