外阴癌腹股沟淋巴结转移的多因素分析  

THE MULTIVARIATE ANALYSIS OF INGUINAL LYMPH NODE METASTASIS IN PATIENTS WITH VULVA CANCER

作　　者：李道成[1] 梁立治[1] 熊樱[1] 

机构地区：[1]中山医科大学肿瘤防治中心妇科,广州510060

出　　处：《肿瘤》2001年第3期194-196,共3页Tumor

摘　　要：目的　探讨用Logistic回归模型预测外阴癌腹股沟淋巴结是否转移 ,以期提高术前诊断的准确率。方法　我院在 196 4～ 1999年间共收治外阴癌 389例 ,其中行外阴广泛切除加双侧腹股沟淋巴结或并盆腔淋巴结清扫的外阴鳞癌2 5 6例 ,本文对此 2 5 6例患者的临床病理资料进行回顾性分析。结果　下列 5个因素与腹股沟淋巴结转移率有关 :(1)中线位置易于出现淋巴结转移 ,且易双侧淋巴结转移 ;(2 )肿瘤直径大于 4cm后转移率上升 ;(3)腹股沟淋巴结的临床状况有一定临床意义 ,但准确性欠佳 ;(4 )肿瘤细胞低分化组腹股沟淋巴结转移率高于其他组 ;(5 )当肿瘤细胞累及淋巴管或血管间隙时易于出现腹股沟淋巴结转移。将此 5个因素引入Logistic回归模型可将腹股沟淋巴结是否转移的预测准确性提高到 87 89%。结论　用Logistic回归模型预测外阴癌腹股沟淋巴结是否转移准确性较高 ,有助于手术前进行准确的临床分期 ,也可为外阴癌的个体化治疗选择合适的方案。Objective To investigate the prediction of inguinal lymph node metastasis by using Logistic regression model in retrospective study of 256 cases of vulva cancers. Methods A total of 389 patients with vulva cancers were treated in our hospital during 1964 1999, 256 patients with squamous cell vulva cancers were treated by radical vulvectomy and bilateral inguinal lymph nodes dissection or together with pelvic nodes dissection.Results The relevant factors were analyzed by using Logistic regression model and 5 important factors were found: (1) Tumor located in midiline were easy to have inguinal lymph nodes metastasis, (2) Tumors≥4 cm had high percentage of metastasis, (3) The clinical characristics were also correlated but was not very accurate, (4) Poor differentiation of tumors were closely related and (5) Positive inguinal lymph nodes occurred more frequently in patients with capillary like spaces than in patients with negative capillary like spaces. Combined use of these 5 factors through the Logistic model, the prediction of inguinal lymph node metastasis rate was 87 89 %. Conclusion Our study demonstrates the feasibility of using Logistic regression model for the prediction of inguinal lymph nodes metastasis in patients with vulva cancers. It can help us to determine the stage of cancer accurately and hence is also useful for the selection of individual treatment in appropriate patients.$$$$

关 键 词：外阴肿瘤 腹股沟淋巴结转移 多因素分析 外阴癌 

分 类 号：R737.35[医药卫生—肿瘤]