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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2021
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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. |
format | Online Article Text |
id | pubmed-8733474 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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