宫颈癌患者MRI术前分期诊断率以及盆腔淋巴结转移的诊断价值分析

The Diagnostic Rate of Preoperative MRI Staging and the Diagnostic Value of Pelvic Lymph Node Metastasis in Patients with Cervical Cancer

目的宫颈癌患者MRI术前分期诊断率以及盆腔淋巴结转移的诊断价值分析。方法选择郑州大学附属洛阳中心医院2019年1月至2021年10月收治的72例患者为研究主体。全部患者在进入医院后均开展核磁共振检查,查看患者手术前核磁共振分期、手术前临床分期和手术后病理分期情况,并将手术后病理分期作为判断的主要依据。比较患者手术前核磁共振分期、手术前临床分期诊断率;分析宫颈癌不同阶段手术前核磁共振诊断情况。结果手术前核磁共振分期诊断符合率为93.06%,手术前临床分期诊断符合率是75.00%,手术前核磁共振分期诊断符合率高于手术前临床分期,差异有统计学意义(P<0.05)。在宫颈癌深肌层浸润手术前,核磁共振检查诊断准确度98.61%、阴性预测值98.46%、阳性预测值100.00%、特异性100.00%、敏感度87.50%。在宫颈癌阴道受累手术前,核磁共振检查诊断准确度86.11%、阴性预测值86.96%、阳性预测值84.62%、特异性90.91%、敏感度78.57%。在宫颈癌旁浸润手术前,核磁共振检查诊断准确度86.11%、阴性预测值76.92%、阳性预测值91.30%、特异性83.33%、敏感度87.50%。在宫颈癌淋巴结节转移手术前,核磁共振检查诊断准确度94.44%、阴性预测值98.31%、阳性预测值76.92%、特异性95.08%、敏感度90.91%。结论宫颈癌患者手术前开展核磁共振检查,能够提升MRI术前分期诊断率,同时在判断盆腔淋巴结转移方面具有较高的诊断效果,可发挥一定干预作用。

Objective To analyse the diagnostic rate of preoperative MRI staging and the diagnostic value of pelvic lymph node metastasis in patients with cervical cancer.Methods A total of 72 patients treated in our hospital from January 2019 to October 2021 were selected as research subjects.All the patients had an MRI examination after entering the hospital,to check the MRI stage before surgery,clinical stage before surgery and pathological stage after surgery,,the pathological stage after operation was taken as the main basis for judgment.The diagnostic rates of preoperative MRI staging and preoperative clinical staging were compared,the MRI diagnosis of cervical cancer at different stages before operation was analyzed.Results The diagnostic coincidence rate of preoperative MRI staging was 93.06%,and that of preoperative clinical staging was 75.00%.The diagnostic coincidence rate of preoperative MRI staging was higher than that of preoperative clinical staging(P<0.05).Before the operation of deep myometrial invasion of cervical cancer,the diagnostic accuracy of MRI was 98.61%,the negative predictive value was 98.46%,the positive predictive value was 100.00%,the specificity was 100.00%,and the sensitivity was 87.50%.Before the operation of vaginal involvement of cervical cancer,the diagnostic accuracy of MRI was 86.11%,the negative predictive value was 86.96%,the positive predictive value was 84.62%,the specificity was 90.91%,and the sensitivity was 78.57%.Before the operation of invasion beside cervical cancer,the diagnostic accuracy of MRI was 86.11%,the negative predictive value was 76.92%,the positive predictive value was 91.30%,the specificity was 83.33%,and the sensitivity was 87.50%.Before cervical cancer lymph node metastasis surgery,the diagnostic accuracy of MRI was 94.44%,the negative predictive value was 98.31%,the positive predictive value was 76.92%,the specificity was 95.08%,and the sensitivity was 90.91%.Conclusion MRI examination of cervical cancer patients before operation can improve the diagnosis rate of MRI staging before operation,and has a high diagnostic effect in judging pelvic lymph node metastasis,which can play a certain role in intervention.