人子宫颈癌盆腔淋巴结转移规律  

The distribution of the pelvic lymph node metastasis in patients with cervical carcinoma

作　　者：张海燕[1] 盛修贵[1] 魏萍[1] 马志芳[1] 马悦冰[1] 刘乃富[1] 

机构地区：[1]山东省肿瘤医院妇瘤科,济南250017

出　　处：《肿瘤》2008年第11期990-993,共4页Tumor

摘　　要：目的:探讨子宫颈癌患者盆腔淋巴结转移的规律。方法:以43例ⅠA2～Ⅳ期子宫颈癌患者作为研究对象,应用正电子发射计算机断层显像(positron emission computed tomography,PET)-CT对这43例各期子宫颈癌患者的盆腔淋巴结转移状态进行分析。结果:盆腔各区域淋巴结转移患者人数和淋巴结组数基本按如下顺序递减:宫旁淋巴结、闭孔淋巴结→髂内淋巴结、髂外淋巴结→髂总淋巴结、腹股沟深淋巴结和腹主动脉旁淋巴结。在接受手术治疗的16例患者中,检测出6组淋巴结转移(均经术后病理证实),大多集中于宫旁和闭孔区域。有6例患者检测到髂总淋巴结转移,5例检测到腹主动脉旁淋巴结转移,均伴有盆腔其他区域的淋巴结转移。结论:子宫颈癌盆腔淋巴结转移存在一定规律:以宫旁和闭孔淋巴结转移率最高;髂内和髂外淋巴结转移率较宫旁和闭孔淋巴结低,但较髂总、腹股沟深和腹主动脉旁淋巴结高;髂总、腹股沟深和腹主动脉旁淋巴结转移率最低。Objective： To explore the distribution of pelvic lymph node metastasis in patients with cervical carcinoma. Methods： The positron emission tomography （PET） -CT was performed to analyze the distribution of pelvic lymph node metastasis in 43 patients with cervical cancer at Ⅰ A2 to Ⅳstage. Results：The metastasis rate of pelvic lymph nodes declines in the following order： paranletrial and obturator lymph nodes→internal iliac and external iliac lymph nodes→common iliac, inguinal and para-aortic lymph nodes. Out of the 16 patients who received surgery, 6 groups of positive lymph node metastasis were identified which were confirmed by postoperative pathological examination. The metastatic lymph nodes were mainly distributed in parametrial and obturatum area. Common iliac metastasis of lymph nodes was detected in 6 patients and para-aortic metastasis was detected in 5 patients. All of the 11 patients has lymph node metastasis in other pelvic regions and died in 5 years. Conclusion：The distribution of pelvic lymph nodes metastasis had some features. The metastatic rate of parametrial and obturator lymph nodes is the highest which can accurately predict the status of pelvic lymph node metastasis. The metastatic rate of internal iliac and external iliac lymph nodes is lower than parametrial and obturator lymph nodes but higher than common lilac, inguinal and para-aortic lymph nodes. The metastatic rate of common iliac, inguinal, and para-aortic lymph nodes is the lowest.

关 键 词：宫颈肿瘤 淋巴转移 正电子发射断层显像 体层摄影术 X线计算机 

分 类 号：R737.33[医药卫生—肿瘤]