Magnetic Resonance Imaging Combined With Tumor Markers In The Diagnosis Of Lymph Node Metastasis And Parametrial Invasion In Cervical Squamous Cell Carcinoma

Objective To discuss the application value of magnetic resonance imaging and tumor markers in the diagnosis of lymph node metastasis and parametrial invasion in cervical squamous cell carcinomaMethod We selected 134 cases of preoperative MRI and detection of tumor markers in patients with cervical squamous cell carcinoma,Compared with pathological resultsand analyzed the clinical value of MRI, serum SCCA and CA125 level in diagnosis of lymph node metastasis and parametrial invasion.Results1)The diagnosis of MRI staging accuracy was 78.4%, 16.4% overvalued,5.2%underestimated.the clinical diagnosis of staging accuracy was 77.6%,12.6%overvalued,9.7% underestimated,there was significant difference between the two groups(p=0.038).2)The sensitivity、specificity、accuracy、positive predictive value、negative predictive value of MRI to detecting parametrial invasion were 42.8%、93.7%、91%、27.2%、96.7%,respectively.5.9% overvalued,2.9% underestimated.The specificity、accuracy、negative predictive value of clinical examination diagnosis to detecting parametrial invasion were 97.6%、92.5%、94.7%,respectively.2.2% overvalued,5.2%underestimated,there was statistically significant difference between the two methods of diagnosis(P=0.039).3)Lymph node metastasis was related to serum SCCA levels 、 vaginal invasion 、parametrial invasion and vascular metastasis.Parametrial invasion was related to serumSCCA levels and clinical staging.Elevated levels of serum SCCA were significantly correlated with lymph node metastasis and the diameter of tumor.The levels of serum CA125 were no significant correlation between different clinical pathological factors.4)The sensitivity、specificity、accuracy、positive predictive value、negative predictive value of MRI to detecting lymph node metastasis were 46.2% 、 93.5% 、 84.3% 、63.1%and87.8%,respectively.The ROC curves showed that serum SCCA levels can predict lymph node metastasis,Diagnosis of optimal critical value was set to3.4ng/ml,the sensitivity、specificity、accuracy、positive predictive value、negative predictive value were 54.7% 、 81.4% 、 82.9% 、 35.7% 、 88.7%,respectively.The combination of the two methods to detecting lymph node metastasis in sensitivity 、specificity 、 accuracy 、positive predictive value、negative predictive value were57.2%、96.8%、89.5%、80% and 90.9%,respectively.5)The ROC curves showed that serum SCCA levels can predict parametrial invasion,Diagnosis of optimal critical value was set to 4.7ng/ml,the sensitivity 、specificity、accuracy、positive predictive value、negative predictive value were 49.7%、85.1%、94.7%、46.7%、95.9%,respectively.Combined with MRI、serum SCCA levels in diagnosis of parametrial invasion in sensitivity 、 specificity 、 accuracy 、 positive predictive value 、 negative predictive value were66.7% 、 97.3% 、 96.1% 、 50%and98.6%,respectively.Conclusion1)MRI diagnosis of FIGO IB-IIB was superior to clinical examination.but MRI was prone to over diagnosis, clinical examination to diagnosis was too low.2)Lymph node metastasis was related to serum SCCA levels 、 vaginal invasion 、parametrial invasion and vascular metastasis.Parametrial invasion was related to serum SCCA levels and clinical staging.3)Elevated levels of serum SCCA were significantly correlated with lymph node metastasis and the diameter of tumor.the optimal critical value of serum SCCA levels in predicting lymph node metastas and parametrial invasion were 3.4ng/ml, 4.7ng/ml.Serum CA125 levels had no significant relationship betweenand lymph node metastasand parametrial infiltration.4)MRI combined with serum SCCA levels in the diagnosis of lymph node metastasis and parametrial invasion were better than the single auxiliary examination, it is the ideal clinical tool.