Abstract

BackgroundCervical cancer shows great differences in depth of invasion, metastasis, and other biological behaviors. The location of the lesion is special, so it is usually difficult to determine the clinical stage. This study aimed to explore the clinical value of magnetic resonance imaging (MRI) and tumor serum markers for the preoperative diagnosis of cervical cancer lymph node metastasis and para-uterine invasion.MethodsA total of 200 patients with cervical cancer admitted to our hospital from January 2019 to January 2020 were collected as the research subjects. Comparing the diagnosis results of preoperative MRI scan, serum tumor markers, and postoperative pathological examination using single factor comparison, we determined the MRI scan results, the comprehensive matching rate between serum tumor markers (squamous cell carcinoma antigen (SCCA), carbohydrate antigen 125 (CA125)) and postoperative pathological results, and the differences of sensitivity, specificity, and accuracy in the prediction of lymph node metastasis and para-uterine infiltration of cervical cancer.ResultsThe levels of SCCA and CA125 in patients with para-uterine invasion and lymph node metastasis were higher than those of patients without invasion and metastasis. Among them, the level of SCCA was significantly different (P<0.05). The level of CA125 was not statistically significant (P>0.05), so MRI combined with serum SCCA was selected for combined diagnosis in the later period. The sensitivity, specificity, and accuracy of MRI diagnosis of cervical cancer and para-uterine infiltrating lymph node metastasis and metastasis were 55.2, 91.6, and 89.5% and 55.2, 91.6, and 89.5%, respectively. These data in MRI combined with serum SCCA were 76.3, 95.3, and 94.3% and 63.2, 96.0, and 95.1%, respectively. The accuracy of tumor markers combined with MRI in the diagnosis of cervical cancer lymph node metastasis and para-uterine invasion was higher than that of MRI.ConclusionsMRI combined with serum SCCA can more accurately identify cervical cancer lymph node metastasis and para-uterine invasion compared with MRI alone. Tumor marker combined with MRI diagnosis is an important auxiliary method for cervical cancer treatment and can provide comprehensive and reliable clinical evidence for evaluation before cervical cancer surgery.

Highlights

  • Cervical cancer shows great differences in depth of invasion, metastasis, and other biological behaviors

  • Inclusion criteria include (A) patients who underwent total hysterectomy combined with pelvic lymphatic dissection and were confirmed to be cervical squamous cell carcinoma by pathological examination of the specimen; (B) patients with Federation Internationale of Gynecologie and Obstetrigue (FIGO) stage ≥ IB stage; (C) patients who received pelvic magnetic resonance imaging (MRI) plain scan + enhanced examination 1 to 2 weeks before treatment; (D) patients with single or multiple tests for tumor markers before treatment; (E) patients with surgical treatment as the initial treatment; and (F) patients without any preoperative chemoradiotherapy

  • This study found that the SCCA level of patients with para-uterine invasion and lymph node metastasis of cervical cancer was significantly higher than that of patients without para-uterine invasion and lymph node metastasis (P

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Summary

Introduction

Cervical cancer shows great differences in depth of invasion, metastasis, and other biological behaviors. This study aimed to explore the clinical value of magnetic resonance imaging (MRI) and tumor serum markers for the preoperative diagnosis of cervical cancer lymph node metastasis and para-uterine invasion. There are about 510,000 new cases of cervical cancer every year, accounting for 9.8% of all cancers. Lymph node metastasis (LNM), one of the major modes of metastasis in cervical cancer, is one of the important factors in determining the prognosis and treatment plan. Due to LNM in some patients with early cervical cancer [9], patients might have been over-treated with more adverse reactions and more complications [10]; it is crucial to discover the treatment strategies and the prediction of prognosis for accurate prediction of LNM in patients with cervical cancer

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