Abstract | BACKGROUND: The assessment of retroperitoneal lymph node status in patients with locally advanced cervical cancer is still a problem. This study aimed to explore the choice of these assessment methods. METHODS: RESULTS: The lymph node metastasis rate was 62.50% and the CILN and/or PALN metastasis rate was 31.25%. Overall, 96 patients had 172 visible lymph nodes. The positive rate of lymph node metastasis was significantly higher in the MAD ≥1.0 cm group (83.33%) than in the 0.5 cm ≤ MAD < 1.0 cm group (26.82%). The critical values of MAD and SCC-Ag in determining lymph node metastasis were 1.0 cm and 5.2 ng/mL, respectively. The accuracy, specificity, and Youden index of MAD ≥1.0 cm combined with SCC-Ag ≥ 5.2 ng/mL for evaluating lymph node metastasis were 75.71%, 100%, and 0.59, respectively, and were significantly different from the values for the MAD ≥1.0 cm (72.09%, 80.56%, and 0.47, respectively) and SCC-Ag ≥ 5.2 ng/mL (71.43%, 68.97%, and 0.42, respectively) groups. Correlation analysis showed that non- squamous cell carcinoma, pelvic lymph node (PLN) MAD ≥1.0 cm plus number ≥ 2, and 1 PLN MAD ≥1.0 cm with CILN and/or PALN MAD 0.5-1.0 cm were risk factors for CILN and/or PALN metastasis. CONCLUSION: Patients with MAD ≥1.0 cm and SCC-Ag ≥ 5.2 ng/mL, as well as high risk factors for CILN and/or PALN metastasis, should undergo resection of enlarged lymph nodes below the common iliac gland and lymphadenectomy of CILN/PALN to reduce tumor burden and to clarify lymph node metastasis status for accurate guidance in follow-up treatment. Patients with MAD < 1.0 cm and SCC-Ag < 5.2 ng/mL may be treated with chemoradiotherapy directly based on imaging, given the low lymph node metastasis rate.
|
Authors | Wei Li, Li Xiong, Qiaoling Zhu, Hong Lu, Meiling Zhong, Meirong Liang, Wei Jiang, Yanan Wang, Wei Cheng |
Journal | BMC cancer
(BMC Cancer)
Vol. 21
Issue 1
Pg. 484
(May 01 2021)
ISSN: 1471-2407 [Electronic] England |
PMID | 33933005
(Publication Type: Journal Article)
|
Chemical References |
- Antigens, Neoplasm
- Serpins
- squamous cell carcinoma-related antigen
|
Topics |
- Adult
- Aged
- Antigens, Neoplasm
(blood)
- Area Under Curve
- Carcinoma
(blood, diagnostic imaging, pathology, therapy)
- Carcinoma, Squamous Cell
(blood, diagnostic imaging, pathology, therapy)
- Female
- Humans
- Laparoscopy
- Lymph Node Excision
(methods)
- Lymph Nodes
(diagnostic imaging, immunology, pathology)
- Lymphatic Metastasis
(pathology)
- Middle Aged
- Radiotherapy, Intensity-Modulated
- Retroperitoneal Space
- Risk Factors
- Sensitivity and Specificity
- Serpins
(blood)
- Tomography, Spiral Computed
- Uterine Cervical Neoplasms
(blood, diagnostic imaging, pathology, therapy)
- Young Adult
|