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