摘要
目的探讨多参数磁共振成像(mpMRI)联合中性粒细胞/淋巴细胞比值(NLR)及血小板/淋巴细胞(PLR)在宫颈癌淋巴结转移中的诊断价值。方法回顾性收集我院2017年7月-2022年9月经病理证实为宫颈癌的93例患者临床资料,术前均行MRI及血清NLR及PLR检查,结合病理结果,依据FIGO 2018版宫颈癌分期,按照腹盆腔淋巴结是否转移分为转移组(n=30)和非转移组(n=63),比较两组临床指标,另通过受试者工作特征曲线(ROC)分析各临床指标的诊断效能,及mpMRI与NLR、PLR联合方案的诊断效能。结果非转移组与转移组肿瘤直径、NLR、PLR、mpMRI诊断、肌层侵犯深度比较,差异有统计学意义(P<0.05)。ROC曲线分析显示,mpMRI、NLR、PLR曲线下面积值分别为0.829、0.668和0.691,且以联合NLR(并联)诊断宫颈癌淋巴结转移的效能最高,其敏感性、特异性、诊断准确性、阳性预测值、阴性预测值分别为0.774、0.971、0.672、0.623、0.975。结论mpMRI、NLR、PLR对宫颈癌淋巴结转移有较好诊断效能,mpMRI联合NLR(并联)提高了宫颈癌淋巴结转移的特异度,能指导临床治疗和术前精准分期。
Objective To investigate the diagnostic value of multi-parameter magnetic resonance imaging(mpMRI)combined with neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in lymph node metastasis of cervical cancer.Methods The clinical data of 93 patients with cervical cancer confirmed by pathology in our hospital from July 2017 to September 2022 were retrospectively collected.All patients underwent MRI and serum NLR and PLR examinations before operation.Combined with pathological results,according to FIGO 2018 cervical cancer staging,the patients were divided into metastasis group(n=30)and non-metastasis group(n=63)according to whether the abdominal and pelvic lymph nodes were transferred.The clinical indicators of the two groups were compared.The diagnostic efficacy of each clinical indicator and the diagnostic efficacy of mpMRI combined with NLR and PLR were analyzed by receiver operating characteristic curve(ROC).Results There were significant differences in tumor diameter,NLR,PLR,mpMRI diagnosis and depth of myometrial invasion between the non-metastasis group and the metastasis group(P<0.05).ROC curve analysis showed that the area under the curve of mpMRI,NLR and PLR were 0.829,0.668 and 0.691,respectively,and MRI combined with NLR(parallel)had the highest efficiency in the diagnosis of lymph node metastasis of cervical cancer,the sensitivity,specificity,diagnostic accuracy,positive predictive value and negative predictive value were 0.774,0.971,0.672,0.623 and 0.975,respectively.Conclusion mpMRI,NLR and PLR have good diagnostic efficacy for lymph node metastasis of cervical cancer.MRI combined with NLR(parallel)improves the specificity of lymph node metastasis of cervical cancer and can guide clinical treatment and preoperative accurate staging.
作者
杨兰英
汤凯
汪静
朱先峰
黄国权
YANG Lan-ying;TANG Kai;WANG Jing;ZHU Xian-feng;HUANG Guo-quan(Department of medical imaging,the Second People's Hospital of Wuhu,Wuhu 241000,Anhui,China)
出处
《医学信息》
2023年第18期160-163,共4页
Journal of Medical Information
基金
中国红十字会基金会影像翼基金项目(编号:V1.0_20210225)
芜湖市第二人民医院院内科研项目(编号:2020D09)。
