Abstract
To explore the significance of magnetic resonance imaging (MRI) combining with detection of serum HE4, TSGF, and CD105 levels in diagnosis and treatment of moderate to advanced cervical cancer. By means of retrospective study, 50 patients diagnosed with moderate to advanced cervical cancer by cervix biopsy pathology examination in our hospital from October 2018 to October 2019 were selected as the study group, and another 50 healthy individuals who did not have cervical cancer after routine gynecological examination and conventional ultrasound examination in the same period were selected as the control group. At the time of enrollment and 3 months after treatment, all study subjects received MRI examination and serological examination, and their HE4 and TSGF levels were measured by the enzyme-linked immunosorbent assay (ELISA) and chromatography method, respectively, and additionally, the immunohistochemistry SP method was adopted for patients in the study group to measure the microvessel density (MVD) marked by CD105. The relationship between MRI staging and FIGO staging was assessed, the efficacy of combining MRI with detection of serum HE4, TSGF, and CD105 levels in diagnosing moderate to advanced cervical cancer was calculated by plotting the ROC curve, and the imaging changes and serological changes of tumor tissue before and after treatment were analyzed. There were 3 of 4 patients in stage IIa and 14 of 15 patients in stage IIIb presenting MRI findings compatible with clinical examinations; 26 patients in stage IIb and 5 patients in stage IVb presenting MRI findings totally compatible with clinical examination. Before treatment, MRI finding of cervical lesion was irregular soft tissue mass, T1WI appeared isointensity or hyperintensity, and obvious lesion enhancement could be seen by enhanced scan. T2WI appeared mixed signal intensity or hyperintensity, with necrotic tissue and fat suppression being hyperintensity. After treatment, lesions shrunk, originally abnormal signals in 5 patients disappeared, and T1WI and T2WI signals in 45 patients presented no difference compared to before treatment. After T1WI enhancement, mild enhancement could be seen in 41 cases and no enhancement in 4 cases. The CD105-MVD of the study group was (68.98 ± 5.23); before and after treatment, the differences in HE4 and TSGF levels between the study group and the control group were significant (P < 0.001). The sensitivity, specificity, and accuracy rate of diagnosis of MRI diagnosis were respectively 82.0% (41/50), 90.0% (45/50), and 86.0% (86/100), and for the diagnosis combining with serum HE4, TSGF, and CD105 levels, they were 96.0% (48/50), 96.0% (48/50), and 96.0% (96/100), respectively, and AUC (95% CI) = 0.960 (0.908-1.000). MRI staging is objective and accurate and has higher sensitivity when combined with serum HE4, TSGF, and CD105 levels in diagnosing moderate to advanced cervical cancer. All MRI, HE4, and TSGF can reflect the treatment effect of patients and are of great importance to efficacy assessment.
Highlights
Cervical cancer is a malignant tumor that occurs in the cervix site with nonspecific symptoms at the early stage, and with the development of the disease, patients can present vaginal bleeding, vaginal discharge, and other symptoms
CD105 belongs to cell membrane glycoprotein and shows a specific expression status on both tumor tissue and surrounding vascular epidermal cells, and a study by Metcalfe et al showed that the microvessel density (MVD) marked by CD105 is closely related to the clinical stage and prognosis of cervical cancer patients [9], which may provide a theoretical basis for cervical cancer treatment
It was a retrospective study conducted in our hospital from October 2018 to October 2019, aiming to explore the meaning of magnetic resonance imaging (MRI) combined with detection of serum HE4, TSGF, and CD105 levels in the diagnosis and treatment of moderate to advanced cervical cancer
Summary
Cervical cancer is a malignant tumor that occurs in the cervix site with nonspecific symptoms at the early stage, and with the development of the disease, patients can present vaginal bleeding, vaginal discharge, and other symptoms. Compared with FIGO, magnetic resonance imaging (MRI) has a better tissue resolution, provides a clearer image of the structural relationship among the cervix, uterus and surrounding tissues and organs, and helps physicians to determine the tumor volume, depth of invasion, and lymph node metastasis, making it a reliable tool to evaluate the clinical stage and treatment effect of patients. CD105 belongs to cell membrane glycoprotein and shows a specific expression status on both tumor tissue and surrounding vascular epidermal cells, and a study by Metcalfe et al showed that the microvessel density (MVD) marked by CD105 is closely related to the clinical stage and prognosis of cervical cancer patients [9], which may provide a theoretical basis for cervical cancer treatment
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