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A nomogram of preoperative indicators predicting lymph vascular space invasion in cervical cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To develop predictive nomograms of lymph vascular space invasion (LVSI) in patients with early-stage cervical cancer.

Methods

We identified 403 patients with cervical cancer from the Affiliated Hospital of Jiangnan University from January 2015 to December 2019. Patients were divided into the training set (n = 242) and the validation set (n = 161), with patients in the training set subdivided into LVSI (+) and LVSI (−) groups according to postoperative pathology. Preoperative hematologic indexes were compared between the two subgroups. Univariate and multivariate logistic regression analyses were used to analyze the independent risk factors for LVSI, from which a nomogram was constructed using the R package.

Results

LVSI (+) was present in 94 out of 242 patients in the training set, accompanied by a significant increase in the preoperative squamous cell carcinoma antigen (SCC), white blood cells (WBC), neutrophil (NE), platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), and tumor size (P < 0.05). Univariate analysis showed that SCC, WBC, NE, NLR, PLR, SII, and tumor size were correlated with LVSI (P < 0.05), and multivariate analysis showed that tumor size, SCC, WBC, and NLR were independent risk factors for LVSI (P < 0.05). A nomogram was correspondingly established with good performance in predicting LVSI [training: ROC-AUC = 0.845 (95% CI: 0.731–0.843) and external validation: ROC-AUC = 0.704 (95% CI: 0.683–0.835)] and high accuracy (training: C-index = 0.787; external validation: C-index = 0.759).

Conclusion

The nomogram based on preoperative tumor size, SCC, WBC, and NLR had excellent accuracy and discriminative capability to assess the risk of LVSI in early-stage cervical cancer patients.

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Data availability

The data used and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

LVSI:

Lymph vascular space invasion

CC:

Cervical cancer

SCC:

Squamous cell carcinoma antigen

WBC:

White blood cells

NE:

Neutrophil

PLT:

Platelet

PLR:

Platelet-to-lymphocyte ratio

NLR:

Neutrophil-to-lymphocyte ratio

SII:

Systemic inflammation index

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Acknowledgements

This study was funded by the Wuxi Taihu Lake Talent Plan, Support for Leading Talents in Medical and Health Profession. We thank Chang Xiong for her help in statistics and analysis of data.

Funding

This study was funded by the Wuxi Taihu Lake Talent Plan, Support for Leading Talents in Medical and Health Profession.

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Author notes

  1. Qu Guo and Yufeng Gao have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Gynecology, Affiliated Hospital of Jiangnan University, Wuxi, China

    Qu Guo, Yufeng Gao, Yaying Lin, Zhenyu Zhang, Yurong Mao & Xizhong Xu

  2. Wuxi Medical College, Jiangnan University, Wuxi, China

    Yufeng Gao & Yaying Lin

  3. Ultrasonography Department, Affiliated Hospital of Jiangnan University, Wuxi, China

    Weimin Li

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  1. Qu Guo
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Contributions

QG: project development, data collection, data analysis, manuscript writing. YG: data analysis, Manuscript writing. YL: data analysis, manuscript writing. WL: data analysis. ZZ: data collection. YM: data collection. XX: data analysis, manuscript writing.

Corresponding author

Correspondence to Xizhong Xu.

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The authors have no relevant financial or non-financial interests to disclose.

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This research was approved by the Ethics Committee of the Affiliated Hospital of Jiangnan University (No. LS2022040).

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Guo, Q., Gao, Y., Lin, Y. et al. A nomogram of preoperative indicators predicting lymph vascular space invasion in cervical cancer. Arch Gynecol Obstet 309, 2079–2087 (2024). https://doi.org/10.1007/s00404-024-07385-6

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