Yang Shimin, Liu Chunli, Li Chunbo, Hua Keqin
Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Shanghai Universal Medical Imaging Diagnostic Center, Shanghai, China.
Front Med (Lausanne). 2022 Jun 30;9:866283. doi: 10.3389/fmed.2022.866283. eCollection 2022.
Accurately predicting the risk level of lymph node metastasis is essential for the treatment of patients with early cervical cancer. The purpose of this study is to construct a new nomogram based on 2-deoxy-2-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and clinical characteristics to assess early-stage cervical cancer patients' risk of lymph node metastasis.
From January 2019 to November 2020, the records of 234 patients with stage IA-IIA [International Federation of Gynecology and Obstetrics (FIGO) 2018] cervical cancer who had undergone PET/CT examination within 30 days before surgery were retrospectively reviewed. A nomogram to predict the risk of lymph node metastasis was constructed based on it. The nomogram was developed and validated by internal and external validation. The validation cohorts included 191 cervical cancer patients from December 2020 to October 2021.
Four factors [squamous cell carcinoma associated antigen (SCCA), maximum standardized uptake value of lymph node (nSUVmax), uterine corpus invasion in PET/CT and tumor size in PET/CT] were finally determined as the predictors of the nomogram. At the area under the receiver operating characteristic curve cohort was 0.926 in the primary and was 0.897 in the validation cohort. The calibration curve shows good agreement between the predicted probability and the actual probability. The decision curve analysis showed the clinical utility of the nomogram.
We had established and verified a simple and effective nomogram, which can be used to predict the lymph node metastasis of cervical cancer patients before surgery.
准确预测淋巴结转移风险水平对于早期宫颈癌患者的治疗至关重要。本研究的目的是基于2-脱氧-2-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）和临床特征构建一种新的列线图，以评估早期宫颈癌患者的淋巴结转移风险。
回顾性分析2019年1月至2020年11月期间234例IA-IIA期[国际妇产科联盟（FIGO）2018]宫颈癌患者的记录，这些患者在手术前30天内接受了PET/CT检查。在此基础上构建了预测淋巴结转移风险的列线图。通过内部和外部验证对列线图进行开发和验证。验证队列包括2020年12月至2021年10月期间的191例宫颈癌患者。
最终确定四个因素[鳞状细胞癌相关抗原（SCCA）、淋巴结最大标准化摄取值（nSUVmax）、PET/CT中的子宫体侵犯和PET/CT中的肿瘤大小]作为列线图的预测因子。在受试者操作特征曲线下面积方面，主要队列中为0.926，验证队列中为0.897。校准曲线显示预测概率与实际概率之间具有良好的一致性。决策曲线分析显示了列线图的临床实用性。
我们建立并验证了一种简单有效的列线图，可用于术前预测宫颈癌患者的淋巴结转移情况。
