Application of Estrogen and Tumor Markers Combined with DCE-MRI in Diagnosis and Clinical Staging of Cervical Cancer

doi:10.11938/cjmr20243133

Abstract

Abstract:

Accurate and reliable diagnosis of cervical cancer is crucial for effective clinical treatment and prognosis evaluation. Given the low sensitivity of existing serum estrogen and tumor markers in assessing lesion features like parauterine invasion and lymph node metastasis, this study proposes a diagnostic method integrating multi-phase dynamic enhanced magnetic resonance imaging (DCE-MRI). Firstly, serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), glycochain antigen 125 (CA125), glycochain antigen 19-9 (CA19-9) and DCE-MRI were detected to analyze the correlation between cervical cancer stage and serum levels of E2, FSH, LH, CA125 and CA19-9. Then, cervical biopsy results were used as the gold standard to analyze the diagnostic accuracy of DCE-MRI for cervical deep muscle invasion and lymph node metastasis. Finally, the serum levels of E2, FSH, LH, CA125, CA19-9, DCE-MRI diagnosis and combined diagnosis of cervical cancer were evaluated based on the receiver operating characteristic (ROC) curve. The experimental results showed that the AUC of combined diagnosis was 0.908, indicating that the combined diagnosis method effectively distinguished benign and malignant cervical lesions. Furthermore, DCE-MRI parameters K^trans and K^ep enriched the feature information, thereby improving the detection accuracy of lesions. This provides a novel approach for differentiating between benign and malignant cervical cancer and for determining its clinical stage.

Key words: estrogen, tumor markers, multi-phase dynamic enhanced magnetic resonance imaging, cervical cancer, combined diagnosis

CLC Number:

O482.53

ZUO Bingyu, SHI Lili, SONG Jia, ZHAO Yang, LI Qian. Application of Estrogen and Tumor Markers Combined with DCE-MRI in Diagnosis and Clinical Staging of Cervical Cancer[J]. Chinese Journal of Magnetic Resonance, 2025, 42(2): 164-173.

Figures/Tables 10

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References 26

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组别	样本数（n）	年龄/岁	BMI/(kg/m²)	文化水平/例，括号内为百分占比
组别	样本数（n）	年龄/岁	BMI/(kg/m²)	初中及以下	初中’高中	大学及以上
对照组	63	47.95±3.26	25.61±0.88	12（19.05%）	28（44.44%）	23（36.51%）
研究组	87	48.04±2.11	25.82±1.01	18（20.69%）	37（42.53%）	32（36.78%）
P		0.838	0.187	0.804	0.815	0.973

分组	样本数（n）	E2/(pmol/L)	FSH/(mIU/mL)	LH/(mIU/mL)	CA125/(U/mL)	CA19-9/(U/mL)
对照组	63	58.15±6.46	14.26±2.89	8.08±2.41	16.15±6.46	19.58±6.72
研究组	87	280.09±13.55	200.48±10.63	211.52±10.75	206.28±10.47	212.47±9.63
t		120.400	135.400	147.400	127.600	136.700
P		<0.001	<0.001	<0.001	<0.001	<0.001

分组	样本数（n）	E2/（pmol/L）	FSH/（mIU/mL）	LH/（mIU/mL）	CA125/（U/mL）	CA19-9/（U/mL）
I期宫颈癌	25	268.88±2.15	191.72±1.87	201.09±0.25	195.92±0.08	205.02±2.18
Ⅱ期宫颈癌	24	278.39±2.83^*	197.44±2.65^*	209.99±2.32^*	205.98±2.69^*	211.28±2.47^*
Ⅲ期宫颈癌	19	289.87±3.35^*#	207.49±3.61^*#	219.08±3.21^*#	212.99±3.34^*#	218.34±3.62^*#
Ⅳ期宫颈癌	19	287.16±5.94^*#	208.82±2.19^*#	219.56±0.16^*#	213.52±3.23^*#	217.91±4.19^*#
F		143.800	214.700	467.900	507.200	90.540
P		<0.001	<0.001	<0.001	<0.001	<0.001

分组	样本（n）	K^trans/(min^-1)	K^ep/(min^-1)	V^e
I期宫颈癌	25	0.13±0.04	0.35±0.13	0.23±0.05
Ⅱ期宫颈癌	24	0.19±0.08^*	0.46±0.26^*	0.25±0.04
Ⅲ期宫颈癌	19	0.25±0.11^*#	0.59±0.17^*#	0.24±0.06
Ⅳ期宫颈癌	19	0.31±0.15^*#▲	0.87±0.21^*#▲	0.26±0.07
F		13.330	26.780	1.210
P		<0.001	0.002	0.311

宫颈活检	深肌层浸润		总计	淋巴结转移		总计
宫颈活检	阳性	阴性	总计	阳性	阴性	总计
阳性	72（82.76%）	10（11.49%）	82（94.25%）	73（83.91%）	10（11.49%）	83（95.40%）
阴性	4（4.60%）	1（1.15%）	5（5.75%）	3（3.45%）	1（1.15%）	4（4.60%）
总计	76（87.36%）	11（12.64%）	87（100.00%）	76（87.36%）	11（12.64%）	87（100.00%）