预测三种不同外阴鳞状细胞癌亚组的淋巴结转移

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-02-20 DOI:10.1016/j.ygyno.2025.02.008

Anne F. van Velzen , Adam J. Tulling , Mariëtte I.E. van Poelgeest , Tjalling Bosse , Helena C. van Doorn , Kim E. Kortekaas , Linda S. Nooij

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引用次数: 0

摘要

目的分析hpv阳性（HPVpos）、hpv阴性p53野生型（HPVneg/p53wt）和hpv阴性p53异常（HPVneg/p53abn）三种不同VSCC亚组淋巴结转移（LNM）的风险，并建立预测模型供临床使用。方法进行回顾性队列研究，收集2000年至2022年间来自两个肿瘤诊所的所有手术治疗的VSCC患者的数据。主要结果是诊断时腹股沟LNM的风险。采用单因素和多因素分析确定LNM的预后变量。建立了一个模型来估计诊断时LNM的概率。结果共纳入516例患者，其中HPVpos 94例（18.2%），HPVneg/p53wt 117例（22.7%），HPVneg/p53abn 305例（59.1%）。LNM率分别为17.0%、26.5%和35.1% （p = 0.002）。在调整年龄、肿瘤大小和侵袭深度后，分子亚组仍然是LNM的重要预测因子（p = 0.028）。利用这些变量建立了一个模型来预测诊断时的LNM。结论hpvneg /p53abn型vscc发生LNM的风险高于HPVpos型vscc。HPVneg/p53wt VSCC被认为是中等危险组。分子亚群有助于LNM诊断时的风险评估。我们开发了一个性能良好，临床可行的模型来预测诊断时LNM的风险。

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Predicting lymph node metastases in three different vulvar squamous cell carcinoma subgroups

Objective

This study aimed to analyze the risk of lymph node metastases (LNM) in three different VSCC subgroups (HPV-positive (HPVpos), HPV-negative p53 wildtype (HPVneg/p53wt) and HPV-negative p53 abnormal (HPVneg/p53abn)), and develop a predictive model for clinical use.

Methods

A retrospective cohort study was performed, collecting data from all surgically treated VSCC patients between 2000 and 2022 from two oncology clinics. The primary outcome was the risk of groin LNM at diagnosis. Prognostic variables for LNM were identified using uni- and multivariate analyses. A model was created to estimate the probability of LNM at diagnosis.

Results

A total of 516 patients were included, of which 94 (18.2 %) were HPVpos, 117 (22.7 %) HPVneg/p53wt, and 305 (59.1 %) HPVneg/p53abn. LNM rates were 17.0 %, 26.5 %, and 35.1 %, respectively (p = .002). Molecular subgroup remained a significant predictor of LNM after adjusting for age, tumor size, and depth of invasion (p = .028). A model using these variables was developed to predict LNM at diagnosis.

Conclusion

HPVneg/p53abn VSCCs have a higher risk of LNM compared to HPVpos VSCCs. HPVneg/p53wt VSCC are considered an intermediate risk group. Molecular subgroups contribute to LNM risk assessment at diagnosis. We developed a well-performing, clinically feasible model to predict the risk of LNM at diagnosis.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy