Volume 22 Issue 1
Jan.  2024
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YOU Huiting, JIN Maosheng, LIU Jian. Predictive value of MRI combined with CDK4 and Ki-67 for lymph node metastasis in early cervical cancer[J]. Chinese Journal of General Practice, 2024, 22(1): 5-9. doi: 10.16766/j.cnki.issn.1674-4152.003318
Citation: YOU Huiting, JIN Maosheng, LIU Jian. Predictive value of MRI combined with CDK4 and Ki-67 for lymph node metastasis in early cervical cancer[J]. Chinese Journal of General Practice, 2024, 22(1): 5-9. doi: 10.16766/j.cnki.issn.1674-4152.003318
shu

Predictive value of MRI combined with CDK4 and Ki-67 for lymph node metastasis in early cervical cancer

doi: 10.16766/j.cnki.issn.1674-4152.003318
  • 1.

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

Funds:

 KJ2019A0363

  • Received Date: 2023-09-02
    Available Online: 2024-03-09
    Abstract
  •   Objective  To explore the predictive value of MRI combined with Cyclin-dependent kinase 4 (CDK4) and Ki-67 in predicting lymph node metastasis of early cervical cancer.  Methods  A total of 101 patients who were diagnosed with cervical cancer for the first time and underwent radical cervical cancer resection in the First Affiliated Hospital of Bengbu Medical College from December 2020 to October 2022 were selected and divided into lymphatic metastasis group (LNM group, n=30) and non-lymphatic metastasis group (NLNM group, n=71) according to pathological results. MRI lymph node metastasis, tumor diameter, stromal infiltration depth, uterine vagina involvement, CDK4, Ki-67 expression and general data were compared between the two groups. The prediction value of lymph node metastasis in early cervical cancer was analyzed.  Results  Single factor results showed that there were statistically significant differences in tumor diameter, SCC-Ag, depth of interstitial invasion, vascular invasion, MRI lymph node metastasis, CDK4 and Ki-67 (P < 0.05). Logistic regression analysis results showed that tumor diameter, squamous cell carcinoma antigen (SCC-Ag), depth of interstitial invasion and Ki-67 were independent risk factors for lymph node metastasis (P < 0.05). The area under the curve (AUC) of CDK4, Ki-67, SCC-Ag and MRI were 0.637, 0.740, 0.792 and 0.857, respectively. The sensitivity were 0.967, 0.833, 0.700, 0.967 and the specificity were 0.282, 0.592, 0.845, 0.634 respectively. The optimal cutoff value of SCC-Ag was 3.6 ng/mL, and the Jorden index was 0.545. The AUC of MRI combined with SCC-Ag in predicting pelvic lymph node metastasis was 0.890, which was smaller than the AUC of MRI combined with CDK4 and Ki-67 in evaluating pelvic lymph node metastasis (0.917), and smaller than the AUC of multiple indicators combined in predicting pelvic lymph node metastasis (0.943, P < 0.05).  Conclusion  MRI alone has low sensitivity in the diagnosis of cervical cancer lymph node metastasis, while CDK4 has high sensitivity but no specificity. When MRI, CDK4 and Ki-67 are combined, both sensitivity and specificity are significantly improved, which has predictive value for preoperative lymph node metastasis.

     

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