宫颈癌宫旁及脉管浸润与分期关系的临床分析  

The clinical analysis of the relationship between parametrial infiltration,as well as lymph-vascular space invasion and staging,prognosis of cervical cancer

作　　者：柴青[1] 郄明蓉[1] 万晓丽[1] 张健[1] 侯敏敏[1] 王红静[1] 刘辉[1] 郑艾[1] 彭芝兰[1] 曹泽毅[1] 

机构地区：[1]四川大学华西第二医院妇科,四川成都610041

出　　处：《中国实用妇科与产科杂志》2009年第10期759-762,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的通过探讨宫颈癌宫旁浸润(parametrial infiltration)及脉管浸润(lymph-vascular space invasion,LVSI)与宫颈癌分期及其他临床病理因素的关系,为提高分期诊断符合率、判断预后提供依据。方法对2005年1月至2007年7月期间四川大学华西第二医院收治的546例子宫颈鳞癌(squamous carcinoma of the cervix,SCC)的临床资料进行回顾性分析,对宫旁和脉管浸润与分期及其他临床、病理因素的关系进行相关分析。结果临床分期中Ⅱb期手术前后诊断符合率(15.9%)最低;脉管浸润的发生随手术病理分期的升高而增加,两者有相关性;单因素分析示宫旁浸润与肿瘤类型、浸润深度、淋巴结转移有关,脉管浸润与肿瘤类型、浸润深度、淋巴结转移、宫旁浸润有关;多因素分析示肿瘤类型和淋巴结转移与宫旁浸润有关,与脉管浸润相关的因素有肿瘤类型、浸润深度和淋巴结转移。结论宫旁浸润是临床分期的难点,脉管浸润能更早地提示淋巴结转移的潜在危险,两者均可通过对内生型肿瘤及淋巴结转移的识别来协助判断。Objective The study was conducted to analyze the relationship between parametrial infiltration or lymph-vascular space invasion（LVSI） of squamous cervical cancer and staging and other histopathologic parameters, in order to increase the coincidence of staging diagnosis and to provide some guidance for choosing treatment regimen and to judge the prognosis. Methods Retrospectively analyzing the clinic data of 546 patients with squamous carcinoma of cervix （SCC） treated in our hospital between January 1,2005 and July 31,2007. Univariable analysis and multivariable analysis were used to evaluate the relationship among parametrial infiltration,LVSI and other histopathologic parameters. Results The coincidence of stage Ⅱ b was the lowest between preand post-operation. The parametrial infiltration appeared to have a significant association with histological type.invasive depth and lymph-nodes metastasis in univariable analysis. While in muhivariable analysis, the parametrial infiltration appeared to have significant association with histological type and lymph-nodes metastasis. And the factors associated with LVSI were histological type,invasive depth and lymph-nodes metastasis. The incidence of LVSI was elevated with the increasing operative-pathologic staging, and there was a statistic significance. Conclusion Parametrial infiltration is a difficult issue when pre-operation clinic staging. LVSI is important for prognosis judgment. Knowing endoor internal cervical cancer and lymph-nodes metastasis can help to recognize parametrial infiltration and LVSI. LVSI can hint the potent danger of lymph-nodes metastasis, and can provide guidance for prognosis judgment and for formulating treatment regimen.

关 键 词：宫颈鳞癌 宫旁浸润 脉管浸润 淋巴结转移 

分 类 号：R71[医药卫生—妇产科学]