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术前评分系统预测宫颈癌淋巴结转移风险。

Preoperative scoring system for the prediction of risk of lymph node metastasis in cervical cancer.

机构信息

College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian, China.

Department of Gynecology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, Fuzhou, 350001, Fujian, China.

出版信息

Sci Rep. 2024 Oct 11;14(1):23860. doi: 10.1038/s41598-024-74871-x.


DOI:10.1038/s41598-024-74871-x
PMID:39394379
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11470059/
Abstract

The study aimed to develop and validate a preoperative scoring system to predict the risk of lymph node metastasis (LNM) in cervical cancer (CC). A total of 426 stage IB1-IIA1 CC patients were randomly divided into two sets. A logistic regression model was used to determine independent factors that contribute to LNM. A preoperative scoring system was developed based on beta (β) coefficients. An area under the receiver operating curve (AUC) was used to test for model discrimination. Five-year overall survival (OS) rate was 91.7%. Multivariable logistic regression analysis showed that FIGO stage, tumor size, depth of invasion on MRI, and squamous cell carcinoma antigen levels were independent risk factors in the development set (all P < 0.05). The AUCs of the scoring system for the development and validation sets were 0.833 (95% CI = 0.757-0.909) and 0.767 (95% CI = 0.634-0.891), respectively. Patients who scored 0-2, 3-5, and 6-8 were classified into low-risk, medium-risk, and high-risk groups. Predicted rates were in accord with observed rates in both sets. The 5-year OS rates of the new groups were also significantly different for the entire group, development set, and validation set (all P < 0.05). LNM affects the prognosis of CC patients. The scoring system can be used to assist in evaluating the risk of LNM in CC patients preoperatively. It is easy to obtain and can provide reference for clinical treatment decision-making.

摘要

本研究旨在开发和验证一种术前评分系统,以预测宫颈癌(CC)淋巴结转移(LNM)的风险。共纳入 426 例ⅠB1-ⅡA1 期 CC 患者,随机分为两组。采用逻辑回归模型确定与 LNM 相关的独立因素。基于β系数建立术前评分系统。采用受试者工作特征曲线下面积(AUC)检验模型的区分度。5 年总生存率(OS)为 91.7%。多变量逻辑回归分析显示,FIGO 分期、肿瘤大小、MRI 浸润深度和鳞状细胞癌抗原水平是发展组中独立的危险因素(均 P<0.05)。评分系统在发展组和验证组的 AUC 分别为 0.833(95%CI=0.757-0.909)和 0.767(95%CI=0.634-0.891)。评分 0-2、3-5、6-8 的患者分别归入低危、中危和高危组。两组的预测率与实际观察率相符。全组、发展组和验证组新分组的 5 年 OS 率差异均有统计学意义(均 P<0.05)。LNM 影响 CC 患者的预后。该评分系统可用于术前评估 CC 患者的 LNM 风险。其易于获取,可为临床治疗决策提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/a03e12bbb798/41598_2024_74871_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/e080ddcaeb1a/41598_2024_74871_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/89cf423d0c20/41598_2024_74871_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/a62e98374c38/41598_2024_74871_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/219cc71345ed/41598_2024_74871_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/98025bd8e519/41598_2024_74871_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/5885ef853a5a/41598_2024_74871_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/a03e12bbb798/41598_2024_74871_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/e080ddcaeb1a/41598_2024_74871_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/89cf423d0c20/41598_2024_74871_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/a62e98374c38/41598_2024_74871_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/219cc71345ed/41598_2024_74871_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/98025bd8e519/41598_2024_74871_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/5885ef853a5a/41598_2024_74871_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49be/11470059/a03e12bbb798/41598_2024_74871_Fig7_HTML.jpg

相似文献

[1]
Preoperative scoring system for the prediction of risk of lymph node metastasis in cervical cancer.

Sci Rep. 2024-10-11

[2]
Preoperative magnetic resonance imaging criteria for predicting lymph node metastasis in patients with stage IB1-IIA2 cervical cancer.

Cancer Med. 2021-8

[3]
Peripheral platelet/lymphocyte ratio predicts lymph node metastasis and acts as a superior prognostic factor for cervical cancer when combined with neutrophil: Lymphocyte.

Medicine (Baltimore). 2016-8

[4]
Correlation Between Squamous Cell Carcinoma Antigen Level and the Clinicopathological Features of Early-Stage Cervical Squamous Cell Carcinoma and the Predictive Value of Squamous Cell Carcinoma Antigen Combined With Computed Tomography Scan for Lymph Node Metastasis.

Int J Gynecol Cancer. 2017-11

[5]
Nomogram for predicting preoperative regional lymph nodes metastasis in patients with metaplastic breast cancer: a SEER population-based study.

BMC Cancer. 2021-5-17

[6]
The 5-year overall survival of cervical cancer in stage IIIC-r was little different to stage I and II: a retrospective analysis from a single center.

BMC Cancer. 2021-2-27

[7]
Predictive Factors of Pelvic Lymph Node Metastasis in Early-Stage Cervical Cancer.

Oncol Res Treat. 2018-3-23

[8]
Preoperative prediction of retroperitoneal lymph node involvement in clinical stage IB and IIA cervical cancer.

J Cancer Res Ther. 2022

[9]
Based on 3D-PDU and clinical characteristics nomogram for prediction of lymph node metastasis and lymph-vascular space invasion of early cervical cancer preoperatively.

BMC Womens Health. 2024-8-2

[10]
Tumor Size at Magnetic Resonance Imaging Association With Lymph Node Metastasis and Lymphovascular Space Invasion in Resectable Cervical Cancer: A Multicenter Evaluation of Surgical Specimens.

Int J Gynecol Cancer. 2018-10

引用本文的文献

[1]
Prediction of lymph node metastasis in cervical cancer patients using AdaBoost machine learning model: analysis of risk factors.

Am J Cancer Res. 2025-3-15

[2]
Metastatic squamous cell carcinoma in the residual spleen diagnosed with emergency ultrasonography: A case report.

Oncol Lett. 2025-2-5

[3]
Risk factors for pelvic lymph node metastasis in cervical cancer: a retrospective analysis of 186 patients.

Front Oncol. 2025-1-31

本文引用的文献

[1]
Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer.

Radiat Oncol. 2022-1-10

[2]
Cancer of the cervix uteri: 2021 update.

Int J Gynaecol Obstet. 2021-10

[3]
The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer.

Eur J Cancer. 2021-10-16

[4]
Recurrence pattern and prognostic factors for survival in cervical cancer with lymph node metastasis.

J Obstet Gynaecol Res. 2021-6

[5]
The Effect of Neoadjuvant Chemotherapy on Lymph Node Metastasis of FIGO Stage IB1-IIB Cervical Cancer: A Systematic Review and Meta-Analysis.

Front Oncol. 2020-11-5

[6]
A Preoperative Risk Prediction Model for Lymph Node Examination of Stage I-III Colon Cancer Patients: A Population-Based Study.

J Cancer. 2020-3-5

[7]
Multiparametric MRI-Based Radiomics Nomogram for Predicting Lymph Node Metastasis in Early-Stage Cervical Cancer.

J Magn Reson Imaging. 2020-9

[8]
Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis.

Lancet Glob Health. 2019-12-4

[9]
Radiomics analysis of magnetic resonance imaging improves diagnostic performance of lymph node metastasis in patients with cervical cancer.

Radiother Oncol. 2019-6-25

[10]
Preoperative prediction of pelvic lymph nodes metastasis in early-stage cervical cancer using radiomics nomogram developed based on T2-weighted MRI and diffusion-weighted imaging.

Eur J Radiol. 2019-3-20

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