摘要
目的分析MRI及鳞状上皮细胞癌抗原(SCC-Ag)联合预测宫颈癌淋巴结转移的价值。方法收集2022年10月~2024年7月就诊于蚌埠医科大学第一附属医院的151例宫颈癌患者临床及MRI图像资料,依据术后病理结果分为非淋巴结转移组(n=83)与淋巴结转移组(n=68),比较两组患者的年龄、肿瘤最大直径、淋巴结短径、宫旁浸润、阴道受累和SCC-Ag水平,结合多项指标评估宫颈癌淋巴结转移的预判价值。结果单因素分析结果表明,影响淋巴结转移的因素有肿瘤最大径、淋巴结短径、宫旁浸润、阴道受累、SCC-Ag水平(P<0.05)。二元Logistic回归分析表明,可预测淋巴结转移风险的肿瘤最大径、淋巴结短径、SCC-Ag、宫旁浸润、阴道受累等均为独立影响因素(P<0.05)。肿瘤最大径、淋巴结短径、SCC-Ag、肿瘤最大径及淋巴结短径联合SCC-Ag、多项指标联合(肿瘤最大径、淋巴结短径、SCC-Ag、宫旁浸润、阴道受累)的ROC曲线下面积分别为0.658、0.972、0.682、0.979、0.988,敏感度分别为62.4%、65.7%、59.3%、78.7%、89.8%,特异度分别为76.7%、88.2%、72.1%、84.5%、86.9%。淋巴结短径、SCC-Ag截断值分别为8.5 mm、5.85 ng/mL,最大约登指数分别为0.652、0.543。结论单独用于淋巴结转移预测的MRI和SCC-Ag敏感度较低,但敏感度和特异度在多种指标联合使用时有显著改善,MRI和SCC-Ag联合使用对淋巴结转移的预测价值较高。
Objective To analyze the value of MRI and squamous cell carcinoma antigen(SCC-Ag)in combination to predict lymph node metastasis of cervical cancer.Methods The clinical and MRI data of 151 patients with cervical cancer who attended the First Affiliated Hospital of Bengbu Medical University from October 2022 to July 2024 were collected and analyzed.All the patients were categorized into non-lymph node metastasis group(n=83)and lymph node metastasis group(n=68)based on postoperative pathological results.Age,maximum tumor diameter,minor diameter of lymph noder,paracervical infiltration,vaginal involvement and the level of SCC-Ag between the two groups of patients were compared,and the prognostic value of lymph node metastasis of cervical cancer was assessed by multiple indicators.Results The results of univariate analysis showed that the factors affecting lymph node metastasis were the maximum diameter of the tumor,minor diameter of lymph noder,vaginal involvement,and the level of SCC-Ag(P<0.05).Binary Logistic regression analysis showed that maximum tumor diameter,minor diameter of lymph node,SCC-Ag,paracentral infiltration,and vaginal involvement were all independent influencing factors that could predict the risk of lymph node metastasis(P<0.05).The area under ROC curve of maximum tumor diameter,minor diameter of lymph node,SCC-Ag,maximum tumor diameter and minor diameter of lymph node,combined with SCC-Ag,multiple indicators combined(maximum tumor diameter,minor diameter of lymph node,SCC-Ag,paracentral invasion,and vaginal involvement)were 0.658,0.972,0.682,0.979,0.988,respectively,sensitivity was 62.4%,65.7%,59.3%,78.7%,89.8%,and specificity was 76.7%,88.2%,72.1%,84.5%,86.9%,respectively.The cut-off values of minor diameter of lymph node,and SCC-Ag were 8.5 mm and 5.85 ng/mL,respectively,and the maximum entry index were 0.652 and 0.543,respectively.Conclusion MRI and SCC-Ag used alone for lymph node metastasis prediction have low sensitivity,while sensitivity and specificity improve significantly when multiple metrics are used in combination,and the predictive value of lymph node metastasis is higher when MRI and SCC-Ag are used together.
作者
单丹丹
邹文涛
晋茂生
马宜传
SHAN Dandan;ZOU Wentao;JIN Maosheng;MA Yichuan(Department of Radiology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China;Department of Gynecology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China)
出处
《分子影像学杂志》
2024年第12期1308-1313,共6页
Journal of Molecular Imaging
基金
安徽省高校科学研究项目(KJ2019A0363)。
关键词
磁共振成像
鳞状细胞癌抗原
宫颈癌
淋巴结转移
magnetic resonance imaging
squamous cell carcinoma antigen
cervical cancer
lymph node metastasis
作者简介
单丹丹,硕士,住院医师,E-mail:1908192225@qq.com;通信作者:马宜传,硕士,主任医师,E-mail:57688754@qq.com。
