Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability

BackgroundAccurate preoperative assessment of lymphovascular space invasion (LVSI) in patients with early-stage cervical squamous cell carcinoma (ECSCC) is clinically significant for guiding treatment decisions and predicting prognosis. However, current LVSI assessment of ECSCC mainly relies on the...

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Main Authors: Junlong Fang, Ming Liu, Zhijing Song, Yifang Zhang, Bo Shi, Jian Liu, Sai Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1562347/full
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author Junlong Fang
Ming Liu
Zhijing Song
Yifang Zhang
Bo Shi
Jian Liu
Sai Zhang
author_facet Junlong Fang
Ming Liu
Zhijing Song
Yifang Zhang
Bo Shi
Jian Liu
Sai Zhang
author_sort Junlong Fang
collection DOAJ
description BackgroundAccurate preoperative assessment of lymphovascular space invasion (LVSI) in patients with early-stage cervical squamous cell carcinoma (ECSCC) is clinically significant for guiding treatment decisions and predicting prognosis. However, current LVSI assessment of ECSCC mainly relies on the invasive method of pathological biopsy, which needs to be further improved in terms of convenience. The main objective of this study is to verify the value of preoperative heart rate variability (HRV) parameters in predicting ECSCC LVSI.MethodsA total of 79 patients with ECSCC confirmed by postoperative pathology were enrolled in this study at the Department of Gynecologic Oncology of the First Affiliated Hospital of Bengbu Medical University. Patients were classified as LVSI-positive (LVSI+) or LVSI-negative (LVSI-) based on pathological examination. Preoperative 5-minute electrocardiogram (ECG) data were collected from all patients, and their HRV parameters were analysed, including 7 time-domain parameters, 5 frequency-domain parameters, and 2 nonlinear parameters. Ten HRV features were selected through univariate analysis, and a logistic model was constructed using age, body mass index, menopausal status, and mean heart rate to predict LVSI status. The model performance was evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, precision, sensitivity, and specificity.ResultsThe constructed model showed good predictive performance, with an AUC of 0.845 (95% CI: 0.761 - 0.930), sensitivity of 0.871, specificity of 0.750, precision of 0.690, and accuracy of 0.747.ConclusionsThe Logistic model constructed based on HRV features has a relatively good diagnostic performance in predicting the LVSI status of ECSCC, but further research is still needed through larger datasets, more features, and the combination of machine learning models.
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spelling doaj-art-afadf683a2ea4b1d9a297a28071cabe32025-08-20T02:41:42ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-07-011510.3389/fonc.2025.15623471562347Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variabilityJunlong Fang0Ming Liu1Zhijing Song2Yifang Zhang3Bo Shi4Jian Liu5Sai Zhang6School of Clinical Medicine, Bengbu Medical University, Bengbu, Anhui, ChinaDepartment of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical University, Bengbu, Anhui, ChinaSchool of Medical Imaging, Bengbu Medical University, Bengbu, Anhui, ChinaDepartment of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical University, Bengbu, Anhui, ChinaSchool of Medical Imaging, Bengbu Medical University, Bengbu, Anhui, ChinaDepartment of Gynecologic Oncology, First Affiliated Hospital, Bengbu Medical University, Bengbu, Anhui, ChinaSchool of Medical Imaging, Bengbu Medical University, Bengbu, Anhui, ChinaBackgroundAccurate preoperative assessment of lymphovascular space invasion (LVSI) in patients with early-stage cervical squamous cell carcinoma (ECSCC) is clinically significant for guiding treatment decisions and predicting prognosis. However, current LVSI assessment of ECSCC mainly relies on the invasive method of pathological biopsy, which needs to be further improved in terms of convenience. The main objective of this study is to verify the value of preoperative heart rate variability (HRV) parameters in predicting ECSCC LVSI.MethodsA total of 79 patients with ECSCC confirmed by postoperative pathology were enrolled in this study at the Department of Gynecologic Oncology of the First Affiliated Hospital of Bengbu Medical University. Patients were classified as LVSI-positive (LVSI+) or LVSI-negative (LVSI-) based on pathological examination. Preoperative 5-minute electrocardiogram (ECG) data were collected from all patients, and their HRV parameters were analysed, including 7 time-domain parameters, 5 frequency-domain parameters, and 2 nonlinear parameters. Ten HRV features were selected through univariate analysis, and a logistic model was constructed using age, body mass index, menopausal status, and mean heart rate to predict LVSI status. The model performance was evaluated by the area under the receiver operating characteristic curve (AUC), accuracy, precision, sensitivity, and specificity.ResultsThe constructed model showed good predictive performance, with an AUC of 0.845 (95% CI: 0.761 - 0.930), sensitivity of 0.871, specificity of 0.750, precision of 0.690, and accuracy of 0.747.ConclusionsThe Logistic model constructed based on HRV features has a relatively good diagnostic performance in predicting the LVSI status of ECSCC, but further research is still needed through larger datasets, more features, and the combination of machine learning models.https://www.frontiersin.org/articles/10.3389/fonc.2025.1562347/fullcervical cancercervical squamous cell carcinomaheart rate variabilitylymphovascular space invasionautonomic nervous system
spellingShingle Junlong Fang
Ming Liu
Zhijing Song
Yifang Zhang
Bo Shi
Jian Liu
Sai Zhang
Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
Frontiers in Oncology
cervical cancer
cervical squamous cell carcinoma
heart rate variability
lymphovascular space invasion
autonomic nervous system
title Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
title_full Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
title_fullStr Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
title_full_unstemmed Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
title_short Predicting lymphovascular space invasion in early-stage cervical squamous cell carcinoma using heart rate variability
title_sort predicting lymphovascular space invasion in early stage cervical squamous cell carcinoma using heart rate variability
topic cervical cancer
cervical squamous cell carcinoma
heart rate variability
lymphovascular space invasion
autonomic nervous system
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1562347/full
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