Clinical Medical College of Jining Medical University, Jining, Shandong, PR China.
Department of Radiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, PR China.
Acta Radiol. 2024 Sep;65(9):1039-1045. doi: 10.1177/02841851241273939. Epub 2024 Aug 28.
Preoperative prediction of lymphovascular space invasion (LVSI) is crucial for improving the prognosis of patients with cervical cancer.
To evaluate the value of preoperative amide proton transfer (APT) imaging combined with serum CA125 levels for predicting LVSI in cervical cancer.
This retrospective study included 80 patients with cervical cancer who underwent preoperative magnetic resonance imaging, including APT imaging. Serum CA125 levels were measured using a fully automated immunoassay analyzer and chemiluminescence method. The presence of LVSI was determined based on the pathological results after surgery.
Among the 40 patients who met the requirements, 29 had postoperative pathological confirmation of LVSI, while 11 did not. The areas under the receiver operating characteristic curves (AUC) of preoperative APT and CA125 levels predicting LVSI were 0.889 and 0.687, respectively. When the APT value was 2.9%, the corresponding Youden index was the highest (0.702), with a sensitivity of 79.3% and specificity of 90.9%. When the critical value of the preoperative serum CA15 level was 25.3 u/mL, the corresponding Youden index was the highest (0.508), with a sensitivity of 69.0% and a specificity of 81.8%. The sensitivity and specificity of preoperative APT imaging combined with serum CA125 in predicting LVSI were 82.7% and 100%, respectively, with a Youden's index of 0.828 and an AUC of 0.923.
The combination of preoperative APT imaging and serum CA125 levels is valuable for predicting LVSI in cervical cancer. Diagnostic efficacy is highest when the APT value is >2.9% and the serum CA125 level is >25.3 u/mL.
术前预测宫颈癌的淋巴血管间隙侵犯（LVSI）对改善患者预后至关重要。
评估术前酰胺质子转移（APT）成像联合血清 CA125 水平预测宫颈癌 LVSI 的价值。
本回顾性研究纳入 80 例宫颈癌患者，均行术前磁共振成像，包括 APT 成像。采用全自动免疫分析仪和化学发光法检测血清 CA125 水平。根据术后病理结果确定 LVSI 的存在。
在符合要求的 40 例患者中，术后病理证实 29 例存在 LVSI，11 例不存在。术前 APT 和 CA125 水平预测 LVSI 的受试者工作特征曲线（AUC）下面积分别为 0.889 和 0.687。当 APT 值为 2.9%时，Youden 指数最高（0.702），灵敏度为 79.3%，特异性为 90.9%。术前血清 CA15 水平临界值为 25.3 u/mL 时，Youden 指数最高（0.508），灵敏度为 69.0%，特异性为 81.8%。术前 APT 成像联合血清 CA125 预测 LVSI 的灵敏度和特异性分别为 82.7%和 100%，Youden 指数为 0.828，AUC 为 0.923。
术前 APT 成像与血清 CA125 联合应用对预测宫颈癌 LVSI 有价值。当 APT 值>2.9%且血清 CA125 水平>25.3 u/mL 时，诊断效能最高。
