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Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram

BACKGROUND: Perineural invasion (PNI) is associated with a poor prognosis for cervical cancer and influences surgical strategies. However, a preoperative evaluation that can determine PNI in cervical cancer patients is lacking. METHODS: After 1:1 propensity score matching, 162 cervical cancer patien...

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Autores principales: Wan, Ting, Cai, Guangyao, Gao, Shangbin, Feng, Yanling, Huang, He, Liu, Lili, Liu, Jihong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733474/
https://www.ncbi.nlm.nih.gov/pubmed/35004296
http://dx.doi.org/10.3389/fonc.2021.774459
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author Wan, Ting
Cai, Guangyao
Gao, Shangbin
Feng, Yanling
Huang, He
Liu, Lili
Liu, Jihong
author_facet Wan, Ting
Cai, Guangyao
Gao, Shangbin
Feng, Yanling
Huang, He
Liu, Lili
Liu, Jihong
author_sort Wan, Ting
collection PubMed
description BACKGROUND: Perineural invasion (PNI) is associated with a poor prognosis for cervical cancer and influences surgical strategies. However, a preoperative evaluation that can determine PNI in cervical cancer patients is lacking. METHODS: After 1:1 propensity score matching, 162 cervical cancer patients with PNI and 162 cervical cancer patients without PNI were included in the training set. Forty-nine eligible patients were enrolled in the validation set. The PNI-positive and PNI-negative groups were compared. Multivariate logistic regression was performed to build the PNI prediction nomogram. RESULTS: Age [odds ratio (OR), 1.028; 95% confidence interval (CI), 0.999–1.058], adenocarcinoma (OR, 1.169; 95% CI, 0.675–2.028), tumor size (OR, 1.216; 95% CI, 0.927–1.607), neoadjuvant chemotherapy (OR, 0.544; 95% CI, 0.269–1.083), lymph node enlargement (OR, 1.953; 95% CI, 1.086–3.550), deep stromal invasion (OR, 1.639; 95% CI, 0.977–2.742), and full-layer invasion (OR, 5.119; 95% CI, 2.788–9.799) were integrated in the PNI prediction nomogram based on multivariate logistic regression. The PNI prediction nomogram exhibited satisfactory performance, with areas under the curve of 0.763 (95% CI, 0.712–0.815) for the training set and 0.860 (95% CI, 0.758–0.961) for the validation set. Moreover, after reviewing the pathological slides of patients in the validation set, four patients initially diagnosed as PNI-negative were recognized as PNI-positive. All these four patients with false-negative PNI were correctly predicted to be PNI-positive (predicted p > 0.5) by the nomogram, which improved the PNI detection rate. CONCLUSION: The nomogram has potential to assist clinicians when evaluating the PNI status, reduce misdiagnosis, and optimize surgical strategies for patients with cervical cancer.
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spelling pubmed-87334742022-01-07 Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram Wan, Ting Cai, Guangyao Gao, Shangbin Feng, Yanling Huang, He Liu, Lili Liu, Jihong Front Oncol Oncology BACKGROUND: Perineural invasion (PNI) is associated with a poor prognosis for cervical cancer and influences surgical strategies. However, a preoperative evaluation that can determine PNI in cervical cancer patients is lacking. METHODS: After 1:1 propensity score matching, 162 cervical cancer patients with PNI and 162 cervical cancer patients without PNI were included in the training set. Forty-nine eligible patients were enrolled in the validation set. The PNI-positive and PNI-negative groups were compared. Multivariate logistic regression was performed to build the PNI prediction nomogram. RESULTS: Age [odds ratio (OR), 1.028; 95% confidence interval (CI), 0.999–1.058], adenocarcinoma (OR, 1.169; 95% CI, 0.675–2.028), tumor size (OR, 1.216; 95% CI, 0.927–1.607), neoadjuvant chemotherapy (OR, 0.544; 95% CI, 0.269–1.083), lymph node enlargement (OR, 1.953; 95% CI, 1.086–3.550), deep stromal invasion (OR, 1.639; 95% CI, 0.977–2.742), and full-layer invasion (OR, 5.119; 95% CI, 2.788–9.799) were integrated in the PNI prediction nomogram based on multivariate logistic regression. The PNI prediction nomogram exhibited satisfactory performance, with areas under the curve of 0.763 (95% CI, 0.712–0.815) for the training set and 0.860 (95% CI, 0.758–0.961) for the validation set. Moreover, after reviewing the pathological slides of patients in the validation set, four patients initially diagnosed as PNI-negative were recognized as PNI-positive. All these four patients with false-negative PNI were correctly predicted to be PNI-positive (predicted p > 0.5) by the nomogram, which improved the PNI detection rate. CONCLUSION: The nomogram has potential to assist clinicians when evaluating the PNI status, reduce misdiagnosis, and optimize surgical strategies for patients with cervical cancer. Frontiers Media S.A. 2021-12-23 /pmc/articles/PMC8733474/ /pubmed/35004296 http://dx.doi.org/10.3389/fonc.2021.774459 Text en Copyright © 2021 Wan, Cai, Gao, Feng, Huang, Liu and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Wan, Ting
Cai, Guangyao
Gao, Shangbin
Feng, Yanling
Huang, He
Liu, Lili
Liu, Jihong
Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title_full Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title_fullStr Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title_full_unstemmed Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title_short Preoperative Evaluation of Perineural Invasion in Cervical Cancer: Development and Independent Validation of a Novel Predictive Nomogram
title_sort preoperative evaluation of perineural invasion in cervical cancer: development and independent validation of a novel predictive nomogram
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8733474/
https://www.ncbi.nlm.nih.gov/pubmed/35004296
http://dx.doi.org/10.3389/fonc.2021.774459
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