314例Ⅰb～Ⅱa期宫颈癌预后及淋巴结转移危险因素研究  

Prognosis and Risk Factors of Lymph Node Metastasis Analysis in 314 Patients with Stage Ib to Ⅱa Cervical Cancer

作　　者：邓欢[1] 李政[2] 李文超[1] 梁卫江[1] 

机构地区：[1]南方医科大学南方医院肿瘤科,广州市510515 [2]中山医科大学肿瘤防治中心妇科

出　　处：《中国肿瘤临床》2012年第10期711-714,共4页Chinese Journal of Clinical Oncology

基　　金：广东省科技计划项目(编号:2007B030703004)资助~~

摘　　要：目的:回顾性研究探讨早期宫颈癌的临床病理特点、预后影响相关因素及淋巴结转移的高危因素。方法:选择1999年1月至2005年1月在中山大学肿瘤防治中心妇科住院治疗的、经病理确诊的314例早期(Ⅰb～Ⅱa期)宫颈癌临床病例资料进行回顾性分析,分析影响其预后及淋巴结转移的高危因素。结果:314例病例5年生存率为88.0%,复发率为13.4%。单因素分析显示深肌层浸润、脉管内瘤栓、淋巴结转移为总生存时间不良因素(P<0.05)。Cox回归分析显示淋巴结转移、深肌层浸润是预后的独立危险因素(P<0.05)。盆腔淋巴结转移组数≥3组与盆腔淋巴结转移组数<3组的生存时间有统计学差异(P=0.032)。单因素分析示SCCAg、FIGO分期、肿瘤直径、深肌层浸润、脉管内瘤栓、宫旁组织浸润均与盆腔淋巴结转移有关(P<0.05)。Logistic回归多因素分析:治疗前SCCAg>3 ng/mL(P<0.001,OR=4.966)、深肌层浸润(P=0.001,OR=5.503)与盆腔淋巴结转移有关。结论:淋巴结转移、深肌层浸润是宫颈癌预后的独立危险因素:治疗前SCCAg>3 ng/mL、深肌层浸润是盆腔淋巴结转移的独立危险因素。Objective： To explore the clinicopathologic characteristics and prognostic factors of cervical cancer and risk factors of lymph node metastasis. Methods： Clinical data of 314 pathologically confirmed cervical cancer patients in Sun Yat-Sen University Cancer Center from January 1999 to January 2005 were analyzed. Results： The 5-year survival rate of these 314 patients was 88.0 % and the recurrence rate was 13.4 %. In univariate survival analysis, the poor prognostic factors included deep stromal invasion, lymph vascular space involvement, and positive pelvic lymph nodes （ P 〈 0.05 ）, whereas in multivariate survival analysis, the independent prognostic factors included positive pelvic lymph nodes and deep stromal invasion （ P 〈 0.05 ）. Patients with ≥3 pelvic lymph node metastasis had poorer prognosis than patients with 〈 3 pelvic lymph node metastasis （ P = 0.032 ）. Univariate analysis showed that the serum level of squamous cell carcinoma antigen （ SCCAg ） 〉 3 ng/mL before treatment, clinical stage, tumor size, deep stromal inva- sion, lymph vascular space involvement, and positive parametrium were associated with pelvic lymph node metastasis （ P 〈 0.05 ）. Fac- tors predictive of pelvic lymph node metastasis on logistic forward regression were SCCAg 〉 3 ng/mL before treatment （ P 〈 0.001, OR = 4.966 ） and deep stromal invasion （ P = 0.001, OR = 5.503 ）. Conclusion： Lymph node metastasis and deep stromal invasion are independent risk factors for prognosis in cervical cancer. SCCAg 〉 3 ng/mL before treatment and deep stromal invasion are indepen- dent risk factors for pelvic lymph node metastasis.

关 键 词：宫颈癌 预后因素 生存期 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]