保留盆腔自主神经与传统宫颈癌根治术保留相关神经组织的组织学对比研究  

Histological Study on Correlative Nerves Preservation for NSRH Comparing with Traditional Radical Hysterectomy

作　　者：龙颖[1] 姚德生[1] 高琨[1] 李力[1] 谢肖兰[1] 

机构地区：[1]广西医科大学附属肿瘤医院,广西南宁530000

出　　处：《实用妇产科杂志》2013年第12期934-937,共4页Journal of Practical Obstetrics and Gynecology

基　　金：广西壮族自治区卫生厅重点科研课题基金资助(编号:200873)

摘　　要：目的：比较保留盆腔自主神经的根治性子宫切除术（NSRH）与传统根治性子宫切除术（RH）中宫骶韧带、主韧带、膀胱宫颈韧带手术切缘神经的分布情况。方法：2008年4月至2011年10月，选择我院FIGO分期为IB～ⅡB期的宫颈癌患者100例，47例采用NSRH，53例为传统的Piver-RutledgeⅢ型宫颈癌根治术，分别取两组手术中宫骶韧带、主韧带和膀胱宫颈韧带的切缘组织进行常规HE、免疫组织化学（S100）、特殊染色（银染）。使用图像分析法对免疫组化的结果图像进行分析，计算神经组织所占的面积比。结果：3种染色方法均能显示神经组织。显微镜下观察：NSRH组患者韧带切缘中的神经组织明显少于RH组。图像分析法：RH组3种韧带切缘s-100蛋白阳性区域所占的神经面积比均明显大于NSRH组，差异有统计学意义（P〈0．05）。结论：NSRH保留盆腔自主神经明显优于RH。Objective：To compare nerves density of surgical margins of uterosacral ligament,cardinal liga- ment and vesicouterine ligament in NSRH with those in RH. Methods：Between April 2008 and October 2011,100 cases with FIGO stage Ⅰ B - Ⅱ B cervical cancer were selected to receive NSRH （study group,47 cases） or Piver-Rutledge Ⅲ radical hysterectomy（RH） （control group,53 cases）. Specimens of surgical mar gins（ uterosacral ligaments, cardinal ligament and vesico-cevical ligament） in NSRH and RH were fixed by 10% formaldehyde. HE staining,silver staining and immunochemistry staining（S100） were performed. Immuno- histochemical outcomes were analyzed by image analytical method to calculate nerves proportion. Results：Nerves could be showed in three staining ways. Nerves were less in study group than those in control group under microscopical view. There was significant difference in nerves proportion between two groups （ P 〈 0. 05）. Conclusions.NSRH is better at preserving pelvic nerves than RH obviously.

关 键 词：盆腔自主神经 根治性子宫切除术 免疫组织化学 

分 类 号：R737.33[医药卫生—肿瘤]