MRI、血清鳞状细胞癌抗原在宫颈癌淋巴结转移及宫旁浸润诊断中临床价值  

Clinical value of MRI,serum squamous cell carcinoma antigen levels in the diagnosis of lymph node metastasis and parametrial infiltration in cervical cancer

作　　者：刘洁曦 牟姗 王露 刘利婷 范凌晔 毛熙光 Jie-xi;MOU Shan;WANG Lu;LIU Li-ting;FAN Ling-ye;MAO Xi-guang(Department of Obstetrics and Gynecoogy,School of Clinical Medicine,Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学临床医学院妇产科,四川泸州646000

出　　处：《临床军医杂志》2024年第2期139-143,共5页Clinical Journal of Medical Officers

基　　金：四川省中医药管理局科学技术研究专项课题(2023MS524)。

摘　　要：目的探讨盆腔MRI、血清鳞状细胞癌抗原(SCCA)、MRI联合SCCA在宫颈癌淋巴结转移和宫旁浸润诊断中的价值。方法回顾性分析自2019年1月至2021年12月于西南医科大学附属医院妇产科就诊的169例宫颈癌患者的临床资料。分析影响术前血清SCCA水平的相关因素,以及MRI、血清SCCA及二者联合在淋巴结转移和宫旁浸润诊断中的价值。结果多因素分析结果显示,病理分期晚、宫旁浸润、肿瘤侵犯深肌层、淋巴结转移、肿瘤直径>4 cm是SCCA水平升高的独立危险因素(P<0.05)。MRI联合血清SCCA时,诊断宫旁浸润的敏感性、特异性、准确率分别为42.8%、97.4%、92.9%;诊断淋巴结转移的敏感性、特异性、准确率分别为67.8%、97.1%、92.3%;诊断非局部晚期淋巴结转移的敏感性、特异性、准确率分别为65.0%、99.2%、94.3%。结论MRI联合血清SCCA检查在宫颈鳞癌淋巴结转移和宫旁浸润的诊断中具有重要的临床应用价值,可以为治疗前评估病情、决策治疗方案提供理论依据。Objective To investigate the value of pelvic MRI,serum squamous cell carcinoma antigen(SCCA),MRI combined with SCCA in the diagnosis of cervical cancer lymph node metastasis and parametrial infiltration.Methods The clinical data of 169 patients with cervical cancer treated in the Department of Obstetrics and Gynecology of Southwest Medical University from January 2019 to December 2021 were retrospectively analyzed.To analyze the related factors affecting preoperative serum SCCA level,and the value of MRI,serum SCCA and their combination in the diagnosis of lymph node metastasis and parametrial infiltration.Results Multivariate analysis showed that late pathological stage,parametrial infiltration,deep muscle invasion,lymph node metastasis,and tumor diameter>4 centimeters were independent risk factors for increased SCCA level(P<0.05).The sensitivity,specificity and accuracy of MRI combined with serum SCCA were 42.8%,97.4% and 92.9%,respectively.The sensitivity,specificity and accuracy of lymph node metastasis were 67.8%,97.1%and 92.3%,respectively.The sensitivity,specificity and accuracy of diagnosis of non-local advanced lymph node metastasis were 65.0%,99.2% and 94.3%respectively.Conclusion MRI combined with serum SCCA examination has important clinical application value in the diagnosis of lymph node metastasis and parametrial infiltration of cervical squamous cell carcinoma,which can provide theoretical basis for evaluating the condition before treatment and making treatment plan.

关 键 词：宫颈癌 淋巴结转移 宫旁浸润 磁共振成像 鳞状细胞癌抗原 

分 类 号：R711.74[医药卫生—妇产科学]