Predictive Model of Adjuvant Radiotherapy for Early Cervical Squamous Cell Carcinoma Based on Nuclear Magnetic Resonance and Squamous Cell Carcinoma Antigen
Objective To establish a model based on nuclear magnetic resonance imaging and squamous cell carcinoma antigen(SCCA)to predict whether early cervical squamous cell carcinoma requires postoperative adjuvant radiotherapy.Methods The clinical data of 67 patients with early cervical squamous cell carcinoma(Ⅰ B1,Ⅰ B2,Ⅱ A1)admitted to the hospital from 2018 to 2021 were collected.The relationship between the lesion size,depth of invasion,degree of tissue differentiation,age,SCCA,apparent diffusion coefficient(ADC)value,human papillomavirus(HPV)subtype and postoperative adjuvant radiotherapy were retrospectively analyzed.Through univariate analysis and multi-factor analysis,independent risk factors that affect postoperative adjuvant radiotherapy were screened out.The receiver operating characteristic(ROC)curve was used to obtain the cut-off point of independent risk factors,and the prediction model was further constructed.Results After univariate analysis,it was found that lesion size(P＜0.001),depth of invasion(P=0.001),degree of tissue differentiation(P=0.002),SCCA(P＜0.001)and ADC value(P＜0.001)affected postoperative adjuvant radiotherapy.After binary logistic regression multivariate analysis,it was found that the size of the lesion(OR=1.201,P=0.021),SCCA(OR=1.608,P=0.033),ADC value(OR=0.013,P=0.043)were independent risk factors affecting adjuvant radiotherapy.The cut-off points obtained by ROC were,SCCA level=4.84 μg·L-1,lesion size=27 mm,ADC value=0.907 × 10-3 mm2·s-1,respectively.When any two indicators were met at the same time,the proportion of postoperative adjuvant radiotherapy was more than 94.7％.Conclusion Tumor size ≥27 mm,ADC value ≤0.907 × 10-3 mm2·s-1,SCCA level ≥4.84 μg·L-1 can be used as indicators for judging adjuvant radiotherapy.If any two indicators are met at the same time,the possibility of adjuvant radiotherapy is obvious.At this time,the treatment method should be carefully considered,and the serious complications caused by the dual treatment mode of radical surgery combine adjuvant radiotherapy should be avoided as much as possible.
万方数据
维普
