术前MRI联合SCCA预测子宫颈鳞状细胞癌淋巴结转移的应用  

Application of Preoperative MRI Combined with SCCA in Predicting Lymph Node Metastasis of Cervical Squamous Cell Carcinoma

作　　者：王芳 郑婧[1] 王惠玲[1] 关崇丽 吴珍珍[1] 赵雅琴 党云[1] 刘青[1] WANG Fang;ZHENG Jing;WANG Huiling;GUAN Chongli;WU Zhenzhen;ZHAO Yaqin;DANG Yun;LIU Qing(Gansu Province Maternity and Child Health Hospital,Lanzhou 730050,China;不详)

机构地区：[1]甘肃省妇幼保健院,甘肃兰州730050

出　　处：《中国医学创新》2023年第27期132-136,共5页Medical Innovation of China

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2020-36)。

摘　　要：目的:探讨术前核磁共振成像(MRI)联合鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCA)预测早期子宫颈鳞状细胞癌淋巴结转移的价值。方法:纳入2014年10月—2019年5月甘肃省妇幼保健院收治的293例子宫颈鳞状细胞癌ⅠA2~ⅡA2期(FIGO 2009)患者的临床资料。通过logistic回归分析术前淋巴结转移的危险因素,受试者操作特征(ROC)曲线分析术前MRI联合SCCA预测子宫颈鳞状细胞癌淋巴结转移的价值。结果:logistic多因素分析发现,SCCA≥1.74 ng/mL[OR=2.149,95%CI(1.055,4.376),P<0.05]为子宫颈鳞状细胞癌淋巴结转移的独立危险因素。ROC曲线分析,SCCA的截断值为1.74 ng/mL,敏感度为53.70%,特异度为70.60%。MRI淋巴结最长径截断值为0.75 cm,敏感度为53.70%,特异度为69.00%。SCCA联合MRI敏感度将显著提高为90.70%,特异度为36.10%。结论:MRI联合血清SCCA可用于术前预测子宫颈鳞状细胞癌淋巴结转移,为子宫颈鳞状细胞癌治疗方案的选择提供参考依据。Objective:To analyze the predictive value of squamous cell carcinoma antigen(SCCA)combined with magnetic resonance imaging(MRI)for lymph node metastasis in early cervical squamous cell carcinoma.Method:The clinical data of 293 patients with cervical squamous cell carcinoma stageⅠA2-ⅡA2(FIGO 2009)admitted to Gansu Province Maternity and Child Health Hospital from October 2014 to May 2019 were included.The risk factors of preoperative lymph node metastasis were analyzed by logistic regression,and the predictive value of preoperative MRI combined with SCCA for lymph node metastasis of cervical squamous cell carcinoma was analyzed by receiver operating characteristic(ROC)curve.Result:Multivariable logistic analysis showed that SCCA≥1.74 ng/mL[OR=2.149,95%CI(1.055,4.376),P<0.05]was independent risk factor for lymph node metastasis of cervical squamous cell carcinoma.ROC curve analysis showed that the cut-off value of SCCA was 1.74 ng/mL,sensitivity was 53.70%,specificity was 70.60%.The cut-off value of longest diameter lymph nodes by MRI was 0.75 cm,sensitivity was 53.70%,specificity was 69.00%.The sensitivity of SCCA combined with MRI was significantly improved to 90.70%,the specificity was 36.10%.Conclusion:MRI combined with serum SCCA can be used to predict preoperative lymph node metastasis of cervical squamous cell carcinoma,and provide reference basis for the selection of treatment scheme of cervical squamous cell carcinoma.

关 键 词：子宫颈癌 淋巴结转移 核磁共振成像 鳞状细胞癌抗原 

分 类 号：R737.33[医药卫生—肿瘤]