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CT在预测宫颈癌淋巴结转移中的应用及术前列线图的构建

Application of CT in predicting lymph node metastasis in cervical cancer and construction of a preoperative nomogram.

作者信息

Meng Xiao, Song Siyu, Li Ke, Duan Yajie, Zhong Jiayuan, Wang Jiawei, Han Shichao

机构信息

Department of Gynecology, The Second Hospital of Dalian Medical University, Dalian, 116023, China.

Department of Graduate School, Dalian Medical University, Dalian, 116044, China.

出版信息

Sci Rep. 2025 Apr 5;15(1):11674. doi: 10.1038/s41598-025-94999-8.

Abstract

Cervical cancer significantly affects women's health, while current preoperative imaging methods for predicting lymph node status are suboptimal. This study aims to evaluate the predictive value of CT attenuation (Hounsfield units) for lymph node metastasis (LNM) in cervical cancer patients and to develop a nomogram integrates clinical and imaging features to improve the accuracy of preoperative assessment. A retrospective analysis was conducted on 132 cervical cancer patients treated at the Second Affiliated Hospital of Dalian Medical University from January 2021 to August 2024. The cohort was divided into a training set (70%) and a validation set (30%) for constructing and evaluating the nomogram. CT attenuation was identified as robust predictors of LNM. Multivariate logistic regression showed that preoperative SCC levels, tumor histology, uterine corpus involvement, and lymphovascular space invasion were independent risk factors for LNM. The nomogram incorporating CT attenuation demonstrated excellent discrimination and calibration. This study presents a simple but robust nomogram that integrates clinical and imaging data to predict lymph node status in cervical cancer patients. The model exhibits high accuracy and reliability, highlighting the utility of CT imaging as a non-invasive preoperative tool for assessing LNM.

摘要

宫颈癌严重影响女性健康,而目前用于预测淋巴结状态的术前成像方法并不理想。本研究旨在评估CT衰减(亨氏单位)对宫颈癌患者淋巴结转移(LNM)的预测价值,并开发一种整合临床和影像特征的列线图,以提高术前评估的准确性。对2021年1月至2024年8月在大连医科大学附属第二医院接受治疗的132例宫颈癌患者进行回顾性分析。该队列被分为训练集(70%)和验证集(30%),用于构建和评估列线图。CT衰减被确定为LNM的可靠预测指标。多因素逻辑回归显示,术前鳞状细胞癌抗原(SCC)水平、肿瘤组织学、子宫体受累情况和脉管间隙浸润是LNM的独立危险因素。纳入CT衰减的列线图显示出良好的区分度和校准度。本研究提出了一种简单但可靠的列线图,该列线图整合了临床和影像数据,以预测宫颈癌患者的淋巴结状态。该模型具有较高的准确性和可靠性,突出了CT成像作为评估LNM的非侵入性术前工具的实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50ee/11972286/4f7a041cb7ce/41598_2025_94999_Fig1_HTML.jpg

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