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. 2021 Nov 24:13:8821-8830.
doi: 10.2147/CMAR.S336268. eCollection 2021.

Heart Rate Variability is an Independent Predictor of Lymph Node Metastasis in Patients with Cervical Cancer

Jingfeng Wang #  1   2 , Jian Liu #  3 , Longfei Gao  3 , Guangqiao Li  1   2 , Yilin Sun  3 , Bo Shi  1   2
Affiliations

Heart Rate Variability is an Independent Predictor of Lymph Node Metastasis in Patients with Cervical Cancer

Jingfeng Wang et al. Cancer Manag Res. .

Abstract

Purpose: Heart rate variability (HRV) has been reported as a useful biomarker for prognostic factors in a variety of cancers. The purpose of this study was to explore the predictive value of preoperative HRV for lymph node metastasis (LNM) in patients with cervical cancer (CC).

Patients and methods: A total of 77 patients with CC were included, including 18 LNM and 59 non-LNM patients. A five-minute resting electrocardiogram (ECG) was collected before surgery for the analysis of HRV time domain, frequency domain and Poincaré plot parameters (ie, SDNN, RMSSD, LF, HF, LF/HF, SD1, SD2 and SD2/SD1). Student's t-tests and logistic regression were performed to determine the relationship between HRV and LNM.

Results: The LNM group had significantly lower SDNN, LF, and SD2 than the non-LNM group (all p < 0.05; all Cohen's d > 0.5). Binary logistic regression analysis indicated that SDNN, LF and SD2 were still significantly associated with LNM. Specifically, for each 1 ms decrease in SDNN and SD2 and each 1 logarithmic unit decrease in ln (LF), the odds of LNM increased by 12%, 9%, and 86%, respectively (all p < 0.05).

Conclusion: These findings suggest an association between HRV and CC LNM, and HRV could be a potential noninvasive biomarker for the prediction of LNM in CC patients.

Keywords: autonomic nervous system; cervical cancer; heart rate variability; lymph node metastasis.

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Conflict of interest statement

A direct family member of B.S. owns stock in HeaLink Ltd., Bengbu, China. Other authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Group differences in HRV parameters between non-LNM and LNM.
Figure 2
Figure 2
Effect size of differences in SDNN, LF and SD2 between the non-LNM and LNM groups.
See this image and copyright information in PMC

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