Markers of Prognosis for Early Stage Cervical Cancer Patients (Stage IB1, IB2) Undergoing Surgical Treatment

Abstract

BackgroundFor individuals with cervical cancer, large tumor volume, lymph node metastasis, distant metastasis, and parauterine infiltration are usually associated with a poor prognosis. Individuals with stage 1B1 and 1B2 cervical cancer usually do not have these unfavorable prognostic factors. Once the disease progresses, the prognosis becomes extremely poor. Therefore, investigating the prognostic markers of these cervical cancer patients is necessary for treatment.MethodsThis retrospective study included 95 cervical cancer patients treated with surgery. The patients were divided into progressor and non-progressor groups according to postoperative follow-up results. T-test (or Mann−Whitney U test), chi-squared test (or Fisher’s exact test) and receiver operating characteristic (ROC) curves were used to evaluate imaging, hematology, and clinicopathological index differences between the two groups. Cox analysis was performed to select the independent markers of progression-free survival (PFS) when developing the nomogram. Validation of the nomogram was performed with 1000 bootstrapped samples. The performance of the nomogram was validated with ROC curves, generated calibration curves, and Kaplan-Meier and decision curve analysis (DCA).ResultsCervical stromal invasion depth, lymphovascular space invasion (LVSI), human papilloma virus (HPV-16), Glut1, D-dimer, SUVmax and SUVpeak showed significant differences between the two groups. Multivariate Cox proportional hazard model showed SUVpeak (p = 0.012), and HPV-16 (p = 0.007) were independent risk factors and were used to develop the nomogram for predicting PFS. The ROC curves, Kaplan-Meier method, calibration curves and DCA indicated satisfactory accuracy, agreement, and clinical usefulness, respectively.ConclusionsSUVpeak level (≥7.63 g/cm3) and HPV-16 negative status before surgery were associated with worse PFS for patients with cervical cancer. Based on this result, we constructed the nomogram and showed satisfactory performance. Clinically, individualized clinical decision-making can be performed on patients based on this result.

Preoperative imaging with positron emission tomography and computed tomography (18F-FDG PET/CT) or contrast-enhanced computed tomography (CECT) scan in operable cervical cancer: a prospective study

“…This metabolic parameter is unavailable in conventional CECT scans and provides complementary information. Our SUV results are concordant with several other studies, which have also shown that this parameter in the primary tumor is an adverse prognostic factor and is associated with lymph node involvement and other features of biologically aggressive malignancy [19][20][21][22]. Given the higher spatial resolution of CECT or MRI and the metabolic information available with PET, the best imaging in clinically early-stage patients may be a combination of PET/CT and CECT or MRI.…”

Preoperative fasting blood glucose combined with age-adjusted D-dimer levels as a predictive score to assess postoperative prognosis of early-stage cervical cancer patients: a retrospective cohort study

“…However, the knowledge about the role of D-dimer in the prognosis of cervical cancer is relatively lacking. Chen et al and Kohei et al studies [14,22] have both shown that D-dimer is an independent prognostic factor for OS in cervical cancer patients. In elderly patients, D-dimer concentrations are higher than the upper limit for normal age, and continued use of standard D-dimer cut-off may compromise accuracy.…”

A Clinical Prognostic Model Based on Preoperative Hematological and Clinical Parameters Predicts the Progression of Primary WHO Grade II Meningioma

“…The “net” constructed by FIB in the extracellular matrix promotes cell adhesion and tumor invasion ( 30 ); in addition, FIB ultimately promotes angiogenesis and tumor growth by binding to growth factors such as vascular endothelial growth factor and fibroblast growth factor-2 ( 31 , 32 ). Previous studies have found that a high level of DD induces the progression of oral squamous cell carcinoma, cervical cancer, and glioma ( 13 , 19 , 33 ). In our study, the AUCs of FIB and DD for the diagnosis of meningioma progression were 0.615 and 0.593 in the training cohort, respectively, and their weighting coefficients in the HRM were 0.199 and 0.712, respectively; this also confirmed that high levels of FIB and DD were risk factors for the progression of AM.…”