Clinical Significance Of MRI Combined With SCC In Predicting Pelvic Lymph Node Metastasis Of Early Cervical Cancer

Purpose:Whether cervical cancer has lymph node metastasis(Lymph node metastasis,LNM)not only determines the prognosis,but also guides the adjuvant treatment after operation,so it is of great significance to study the correlation of LNM.The clinical significance of magnetic resonance imaging(magnetic resonance imaging,MRI)combined with squamous cell carcinoma antigen(squamous cell carcinoma antigen,SCC)in predicting pelvic LNM of cervical cancer was studied,and the related factors of pelvic LNM in cervical cancer were also analyzed.Methods:The clinical data of 110 patients with stage?a-?a cervical squamous cell carcinoma treated in our hospital from July 2016 to March 2018 were retrospectively analyzed.Univariate and multivariate analysis was performed on the factors that might affect pelvic LNM,including age,SCC value,depth of interstitial infiltration,clinical stage,tumor diameter,incisor margin infiltration and vascular infiltration.The SCC value and the results of MRI were collected and analyzed by SPSS22.0 software.The optimal cut-off value of serum SCC for diagnosis of pelvic LNM in cervical cancer was calculated.The selected factors were analyzed by univariate analysis,and the multivariate analysis was carried out in the univariate analysis.Results:The area under the curve of SCC to determine the operating characteristics of pelvic lymph node metastasis of cervical cancer in subjects with(receiver operating characteristic,ROC curve is 0.695.The best critical value was 2.45ng/mL,and 95%CI was 0.577-0.812.The positive predictive value was 46%,and the negative predictive value was 84%,the diagnostic accuracy was 71%,the sensitivity was 58.6%,and the specificity was 75.3%,Kappa=0.312,P=0.001.The positive predictive value of preoperative MRI in the diagnosis of pelvic lymph node metastasisin cervical squamous cell carcinoma was 77%.The negative predictive value was89%.The accuracy rate was 86.4%.The sensitivity was 69%.The specificity of 92.6%,kappa was 0.637,P=0.000.The positive predictive value of the combined diagnosis of pelvic lymph node metastasis of cervical squamous cell carcinoma was 55%,the negative predictive value was 97%,the accuracy was 78.1%,the sensitivity was93.1%,the specificity was 72.8%,Kappa was 0.540,P=0.000.In univariate analysis,lymph node metastasis was associated with SCC>2.45 ng/mL,depth of interstitial infiltration,incision margin infiltration and vascular infiltration.Multivariate analysis showed that interstitial infiltration and vascular infiltration were independent risk factors for pelvic lymph node metastasis.Conclusion: Pelvic lymph node metastasis is associated with SCC >2.45ng/mL,depth of interstitial invasion,incision margin infiltration and vascular infiltration.Especially when the interstitial infiltration and vascular infiltration are present,the possibility of lymph node metastasis could not be ignored.For the diagnosis of lymph node metastasis,MRI is superior to SCC.When SCC is combined with MRI,the sensitivity and negative predictive value can be significantly improved,which has important clinical significance for the diagnosis of cervical cancer without pelvic lymph node metastasis.