{"title":"The value of multiparameter MRI of early cervical cancer combined with SCC-Ag in predicting its pelvic lymph node metastasis","authors":"Xiaoqian Xu, Fenghai Liu, Xinru Zhao, Chao Wang, Da Li, Liqing Kang, Shikai Liu, Xiaoling Zhang","doi":"10.3389/fonc.2024.1417933","DOIUrl":null,"url":null,"abstract":"PurposeTo investigate the value of multiparameter MRI of early cervical cancer (ECC) combined with pre-treatment serum squamous cell carcinoma antigen (SCC-Ag) in predicting its pelvic lymph node metastasis (PLNM).Material and methods115 patients with pathologically confirmed FIGO IB1~IIA2 cervical cancer were retrospectively included and divided into the PLNM group and the non-PLNM group according to pathological results. Quantitative parameters of the primary tumor include K<jats:sup>trans</jats:sup>, K<jats:sub>ep</jats:sub>, V<jats:sub>e</jats:sub> from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), ADC<jats:sub>mean</jats:sub>, ADC<jats:sub>min</jats:sub>, ADC<jats:sub>max</jats:sub>, D, D<jats:sup>*</jats:sup> and f from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) were measured. Pre-treatment serum SCC-Ag was obtained. The difference of the above parameters between the two groups were compared using the student t-test or Mann-Whitney U test. Multivariate Logistic regression analysis was performed to determine independent risk factors. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic efficacy of individual parameters and their combination in predicting PLNM from ECC.ResultsThe PLNM group presented higher SCC-Ag [14.25 (6.74,36.75) ng/ml vs.2.13 (1.32,6.00) ng/ml, <jats:italic>P</jats:italic>&lt;0.001] and lower K<jats:sup>trans</jats:sup> (0.51 ± 0.20 min<jats:sup>-1</jats:sup> vs.0.80 ± 0.33 min<jats:sup>-1</jats:sup>, <jats:italic>P</jats:italic> &lt; 0.001), ADC<jats:sub>mean</jats:sub> (0.85 ± 0.09 mm/s<jats:sup>2</jats:sup> vs.1.06 ± 0.35 mm/s<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic>&lt;0.001), ADC<jats:sub>min</jats:sub> [0.67 (0.61,0.75) mm/s<jats:sup>2</jats:sup> vs. 0.75 (0.64,0.90) mm/s<jats:sup>2</jats:sup>, <jats:italic>P</jats:italic> = 0.012] and f (0.91 ± 0.09 vs. 0.27 ± 0.14, <jats:italic>P</jats:italic> = 0.001) than the non-LNM group. Multivariate analysis showed that SCC-Ag (OR = 1.154, <jats:italic>P</jats:italic> = 0.007), K<jats:sup>trans</jats:sup> (OR=0.003, <jats:italic>P</jats:italic> &lt; 0.001) and f (OR = 0.001, <jats:italic>P</jats:italic>=0.036) were independent risk factors of PLNM. The combination of SCC-Ag, K<jats:sup>trans</jats:sup> and f possessed the best predicting efficacy for PLNM with an area under curve (AUC) of 0.896, which is higher than any individual parameter: SCC-Ag (0.824), K<jats:sup>trans</jats:sup> (0.797), and f (0.703). The sensitivity and specificity of the combination were 79.1% and 94.0%, respectively.ConclusionsQuantitative parameters K<jats:sup>trans</jats:sup> and f derived from DCE-MRI and IVIM-DWI of primary tumor and SCC-Ag have great value in predicting PLNM. The diagnostic efficacy of their combination has been further improved.","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":null,"pages":null},"PeriodicalIF":3.5000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fonc.2024.1417933","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
PurposeTo investigate the value of multiparameter MRI of early cervical cancer (ECC) combined with pre-treatment serum squamous cell carcinoma antigen (SCC-Ag) in predicting its pelvic lymph node metastasis (PLNM).Material and methods115 patients with pathologically confirmed FIGO IB1~IIA2 cervical cancer were retrospectively included and divided into the PLNM group and the non-PLNM group according to pathological results. Quantitative parameters of the primary tumor include Ktrans, Kep, Ve from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), ADCmean, ADCmin, ADCmax, D, D* and f from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) were measured. Pre-treatment serum SCC-Ag was obtained. The difference of the above parameters between the two groups were compared using the student t-test or Mann-Whitney U test. Multivariate Logistic regression analysis was performed to determine independent risk factors. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic efficacy of individual parameters and their combination in predicting PLNM from ECC.ResultsThe PLNM group presented higher SCC-Ag [14.25 (6.74,36.75) ng/ml vs.2.13 (1.32,6.00) ng/ml, P<0.001] and lower Ktrans (0.51 ± 0.20 min-1 vs.0.80 ± 0.33 min-1, P < 0.001), ADCmean (0.85 ± 0.09 mm/s2 vs.1.06 ± 0.35 mm/s2, P<0.001), ADCmin [0.67 (0.61,0.75) mm/s2 vs. 0.75 (0.64,0.90) mm/s2, P = 0.012] and f (0.91 ± 0.09 vs. 0.27 ± 0.14, P = 0.001) than the non-LNM group. Multivariate analysis showed that SCC-Ag (OR = 1.154, P = 0.007), Ktrans (OR=0.003, P < 0.001) and f (OR = 0.001, P=0.036) were independent risk factors of PLNM. The combination of SCC-Ag, Ktrans and f possessed the best predicting efficacy for PLNM with an area under curve (AUC) of 0.896, which is higher than any individual parameter: SCC-Ag (0.824), Ktrans (0.797), and f (0.703). The sensitivity and specificity of the combination were 79.1% and 94.0%, respectively.ConclusionsQuantitative parameters Ktrans and f derived from DCE-MRI and IVIM-DWI of primary tumor and SCC-Ag have great value in predicting PLNM. The diagnostic efficacy of their combination has been further improved.
期刊介绍:
Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.