Diagnostic Value Of Preoperative CT Scan And Serum SCC-Ag For Retroperitoneal Lymph Node Metastasis In Patients With Cervical Squamous Cell Carcinoma

Objective:To determine the value of preoperative CT scan and serum squamous cell carcinoma antigen(SCC-Ag)alone and in combination for the diagnosis of retroperitoneal lymph node metastasis in patients with cervical squamous cell carcinoma.Methods: A total of 132 treatment-naive patients with cervical squamous cell carcinoma confirmed by cervical biopsy and postoperative pathologic examinations who were admitted to Jiangxi Maternal and Child Health Hospital from 2014 to 2017 were enrolled.Whole-abdominal CT scan was performed prior to surgery and the minimum diameters of the transverse axis of para-aortic and pelvic lymph nodes were measured.Venous blood samples were collected,and SCC-Ag was determined using a microparticle enzyme immunoassay.The presence of retroperitoneal lymph node metastasis was identified by postoperative pathologic examinations.Results: Of these 132 patients,postoperative pathologic examinations revealed retroperitoneal lymph node metastasis in 38 cases(28.8%)and no metastasis in 94 cases(71.2%).The area under the ROC curve was 0.803 [95%CI(0.714,0.893),P<0.001] and 0.778 [95%CI(0.699,0.857),P<0.001] for the minimum diameter of the transverse axis of lymph nodes on preoperative CT scans and serum SCC-Ag in the diagnosis of retroperitoneal lymph node metastasis,respectively,When the cut-off value of the minimum diameter of the transverse axis of lymph nodes on CT scans was 0.765 cm,the corresponding Youden's index was greatest(0.488),and the sensitivity,specificity and accuracy were 65.8%,83.0% and 78.0%,respectively.When the cut-off value of preoperative serum SCC-Ag level was 3.31?g/L,the corresponding Youden's index was greatest(0.424),and the sensitivity,specificity and accuracy were 65.8%,76.6% and 73.5%,respectively.In addition,the combination of preoperative CT scan and serum SCC-Ag had a sensitivity of 78.9%,a specificity of 70.2%,a Youden's index of 0.491,and an accuracy of 72.7% for the diagnosis of retroperitoneal lymph node metastasis.Conclusion: The use of minimum diameter of the transverse axis of lymph nodes ? 0.765 cm and serum SCC-Ag ? 3.31 ?g/L were the optimal values for the diagnosis of retroperitoneal lymph node metastasis in patients with cervical squamous cell carcinoma,and the combination of CT scan and SCC-Ag may improve the diagnostic sensitivity.