Prediction Of Lymph Node Metastasis In Early Cervical Cancer By MRI Combined With Preoperative Serological Indices And Pathological Features

Objective: To investigate the predictive value of MRI combined with preoperative serum markers squamous cell carcinoma antigen(SCC-Ag),neutrophil to lymphocyte ratio(NLR)and biopsy pathology for lymph node metastasis(LNM)in early cervical cancer.Methods: A total of 307 patients with cervical cancer who underwent initial surgery in the First Affiliated Hospital of Bengbu Medical College from January2019 to February 2022 were selected and grouped according to whether there was lymph node metastasis after surgery.The short diameter of MRI lymph nodes,tumor diameter,depth of interstitial infiltration,parametrial and vaginal inv olvement,preoperative serological indicators and clinicopathological features were compared between the two groups.The predictive value and significance of combined diagnosis for lymph node metastasis were analyzed.Results: Univariate analysis showed that MRI lymph node short diameter,tumor diameter,depth of interstitial infiltration,suspected parametrial infiltration and vaginal involvement,clinical stage,preoperative SCC-Ag level,NLR value,vascular infiltration and other factors affected lymph node metastasis of cervical squamous cell carcinoma.Logistic regression analysis showed that large short diameter of MRI lymph nodes,large diameter of MRI tumor,MRI interstitial infiltration depth greater than 1 / 2 muscular layer,suspicious parametrial infiltr ation signs on MRI,increased preoperative SCC-Ag level and vascular infiltrati on were independent risk factors for lymph node metastasis of cervical cancer(all P < 0.05).The area under the ROC curve of MRI lymph node short diameter,preoperative SCC-Ag level and NLR in the diagnosis of cervical cancer LNM was 0.806,0.711 and 0.630,respectively.The best cut-off values were8.50 mm,2.55 ng / mL and 1.90,respectively.The sensitivity was 0.654,0.593 and 0.593,and the specificity was 0.881,0.757 and 0.642,respectively.The area under the ROC curve of MRI lymph node short diameter combined with SCC-Ag was 0.846.The area under the ROC curve of MRI lymph node short diameter,SCC-Ag level and NLR was 0.863.The area under the ROC curve of multi-index(preoperative SCC-Ag level,MRI lymph node short diameter,tumor diameter,interstitial infiltration depth,suspicious parametrial infiltration,and vascular infiltration)combined diagnosis of cervical cancer LNM was 0.926.Conclusion: 1.The short diameter of MRI lymph nodes,the diameter of MRI tumor,the depth of MRI interstitial infiltration greater than 1 / 2 muscle layer,the presence of suspicious parametrial infiltration signs on MRI,the increase of preoperative SCC-Ag level and vascular infiltration were independent risk factors for lymph node metastasis in early cervical squamous cell carcinoma.2.Univariate analysis of NLR has a certain predictive effect on lymph node meta stasis in early cervical cancer,and multivariate analysis is meaningless.3.Comb ining imaging examination(MRI)with serological indicators(SCC,NLR)and clinicopathological features can improve the diagnosis of preoperative retroperitoneal lymph node metastasis in cervical squamous cell carcinoma.