阴道超声参数构建评分模型早期预测子宫内膜癌淋巴结转移的价值  

The value of constructing a scoring model based on vaginal ultrasound parameters for early prediction of lymph node metastasis in endometrial cancer

作　　者：魏彦萍[1] 安小琴 胡双环 徐翠霞[1] WEI Yanping;AN Xiaoqin;HU Shuanghuan;XU Cuixia(Functional Department,People's Hospital of Guyuan City,Guyuan 756000,China)

机构地区：[1]宁夏固原市人民医院功能科,宁夏固原756000

出　　处：《宁夏医学杂志》2023年第1期51-54,共4页Ningxia Medical Journal

摘　　要：目的探讨基于阴道超声参数构建评分模型早期预测子宫内膜癌淋巴结转移的价值。方法纳入接受子宫内膜癌根治术,且术中行淋巴结清扫治疗的患者150例。根据术后病理检查结果是否存在淋巴结转移分为淋巴结转移组(LN组)和未转移组(NLN组);收集2组患者临床资料、阴道超声检查指标,采用多因素logistic回归方程分析子宫内膜癌淋巴结转移的危险因素并建立阴道超声参数评分模型(LNPM),分析该模型在术前预测子宫内膜癌淋巴结转移的诊断效能,同时另外选取80例子宫内膜癌根治术患者对建立阴道超声参数评分模型进行外部验证。结果150例患者经术后病理评估共出现31例淋巴结转移,据此分为LN组31例和NLN组119例。LN组患者的肌层浸润深度(≥50%)、子宫内膜厚度、癌灶内血流最大速度(Vmax)、阻力指数(RI)、术前癌抗原125(CA125)水平、分化程度与NLN组比较有统计学意义(P<0.05);肌层浸润深度(≥50%,OR=13.454)、Vmax大(OR=3.598)、RI小(OR=0.383)、分化程度低(OR=1.003)是导致淋巴结转移的危险因素(P<0.05);LNPM预测子宫内膜癌淋巴结转移的AUC=0.815,高于分化程度(AUC=0.668),其预测敏感度为83.78%、特异度为69.23%。另外选取80例子宫内膜癌根治术患者中20例出现淋巴结转移,60例未出现淋巴结转移,外部验证显示,基于经阴道超声参数预测模型预测EC患者LN转移的AUC为0.798(95%CI 0.697~0.088),预测敏感度为95.00%、特异度为58.33%。结论基于阴道超声参数构建评分模型能够用于早期评估子宫内膜癌淋巴结转移风险,能够科学指导临床制定治疗方案。Objective To explore the value of constructing a scoring model based on vaginal ultrasound parameters for early prediction of lymph node metastasis in endometrial cancer.Methods 150 patients who underwent radical resection of endometrial cancer and the patients who received intraoperative lymph node dissection were included in the study.According to the results of postoperative pathological examination,whether there was lymph node metastasis the patients were divided into lymph node metastasis group(LN group)and non-metastatic group(NLN group).Collected the clinical data of patients in two groups undergoing vaginal ultrasound examination and analyzed the risk factors of endometrial cancer lymph node metastasis;Multivariate logistic regression equation was used to analyze the risk factors of lymph node metastasis of endometrial cancer,and a transvaginal ultrasound parameter scoring model(LNPM)was established to analyze the diagnostic performance of the model in predicting lymph node metastasis of endometrial cancer before surgery.At the same time,another 80 cases of patients undergoing radical endometrial carcinoma were selected to establish the vaginal ultrasound parameter scoring model for external verification.Results A total of 31 cases of lymph node metastasis were found in 150 patients by postoperative pathological evaluation,and were divided into LN group with 31 cases and NLN group with 119 cases.In the LN group,the depth of myometrial invasion(≥50%),endometrial thickness,maximum velocity of blood flow(Vmax)in the tumor focus,resistance index(RI)and preoperative cancer antigen 125(CA-125)level were statistically different between the degree of differentiation and the NLN group(P<0.05);Multivariate logistic regression analysis showed that the depth of myometrial invasion(≥50%)(OR=13.454),the larger the Vmax(OR=3.598),the smaller the RI(OR=0.383)and the lower the degree of differentiation(OR=1.003).Independent risk factors leading to lymph node metastasis(P<0.05);ROC curve analysis showed that the AUC of

关 键 词：阴道超声 子宫内膜癌 淋巴结转移 评分模型 

分 类 号：R737.33[医药卫生—肿瘤]