增强CT淋巴结短径及SCC-Ag在术前预测宫颈鳞癌淋巴结转移中的应用

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摘要目的探讨增强CT淋巴结短径及鳞状细胞癌抗原（SCC-Ag）在术前预测宫颈鳞癌淋巴结转移患者诊断中的应用。方法选取2019年10月至2020年12月于首都医科大学附属北京妇产医院接受宫颈癌根治术的宫颈鳞癌ⅠA1～ⅢCr期患者。通过单因素分析评价与淋巴结转移相关的因素，建立评价淋巴结转移的预测模型，并评价模型的预测价值。结果共纳入患者189例，其中淋巴结转移组30例。两组肿瘤最大径线、临床分期、细胞分化、术前血清SCC-Ag及增强CT淋巴结短径差异有统计学意义（P ＜ 0.001），年龄及HPV感染差异无统计学意义（P ＞ 0.05）。增强CT淋巴结短径预测宫颈鳞癌淋巴结转移的最佳截断值为0.625 cm，曲线下面积（AUC）值为0.827（P ＜ 0.001），敏感度为66.7%，特异度为83.0%；SCC-Ag预测宫颈鳞癌淋巴结转移的最佳截断值为1.88 ng/ml，AUC值为0.733（P ＜ 0.001），敏感度为66.7%，特异度为73.6%；两者联合检测AUC值为0.802（P ＜ 0.001），敏感度为66.7%，特异度84.3%。结论血清SCC-Ag及增强CT淋巴结短径的检测可用于评估宫颈鳞癌患者淋巴结转移，且CT淋巴结短径单独诊断价值更高，为临床制订治疗方案提供参考依据。

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	秦琳吴玉梅王明魏佳慧

关键词 ：宫颈鳞癌, 淋巴结转移, 鳞状细胞癌抗原, 增强CT, 淋巴结短径

Abstract：Objective To investigate the application value of the shortest diameter of lymph nodes in enhanced CT and squamous cell carcinoma antigen (SCC-Ag) in diagnosing lymph node metastasis pre-operation in cervical squamous cell cancer. Methods Patients with cervical squamous cell carcinoma ⅠA1-ⅢCr stage who underwent radical cervical surgery in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2019 to December 2020 were selected. By single factor analysis and evaluation of the factors related to lymph node metastasis, the prediction model of lymph node metastasis was established and the predictive value of the model was evaluated. Results A total of 189 patients were included, including 30 in the lymph node metastasis group. There were statistically significant differences in maximum diameter, clinical stage, cell differentiation, preoperative serum SCC-AG and enhanced CT lymph node short diameter between the two groups (P ＜ 0.001), but there were no statistically significant differences in age and HPV infection (P ＞ 0.05). The best truncation value was 0.625cm, area under curve (AUC) value was 0.827 cm (P ＜ 0.001), sensitivity was 66.7%, and specificity was 83.0%, respectively. The optimal cut-off value of SCC-AG in predicting cervical squamous cell carcinoma lymph node metastasis was 1.88 ng/ml, AUC value was 0.733 (P ＜ 0.001), sensitivity was 66.7%, and specificity was 73.6%. The AUC value of the combined detection was 0.802 (P ＜ 0.001), the sensitivity was 66.7%, and the specificity was 84.3%. Conclusion SCC-Ag and the shortest diameter of lymph nodes in enhanced CT can be used to evaluate lymph node metastasis in patients with cervical squamous cell carcinoma,and the diagnostic value of the shortest diameter of lymph nodes in enhanced CT is higher,which provides a reference for clinical treatment planning.

Key words： Squamous cell carcinoma antigen Lymph node metastasis Squamous cell carcinoma antigen Enhanced CT Shortest diameter of lymph nodes

基金资助:北京市科学技术委员会重点项目（Z1911000 06619035）；
北京市医院管理局临床医学发展专项——“扬帆计划”项目（ZYLX201705）。

通讯作者: 吴玉梅（1959.11-），女，博士，主任医师，博士生导师；研究方向：妇科肿瘤。

作者简介: 秦琳（1987.3-），女，首都医科大学2019级妇产科学专业在读硕士研究生，现任职解放军总医院第七医学中心妇产医学部派驻第四医学中心妇产科；研究方向：妇科肿瘤。

引用本文:

秦琳吴玉梅王明魏佳慧. 增强CT淋巴结短径及SCC-Ag在术前预测宫颈鳞癌淋巴结转移中的应用[J]. 中国医药导报, 2022, 19(5): 124-128.
QIN Lin WU Yumei WANG Ming WEI Jiahui. Application of the shortest diameter of lymph nodes in enhanced CT and SCC-Ag predicting pre-operation lymph node metastasis in cervical squamous cell carcinoma#br#. 中国医药导报, 2022, 19(5): 124-128.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I5/124

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