早期宫颈癌宫旁转移相关因素研究进展  

Research Progress of Factors Associated with Parametrial Involvement of Early Cervical Cancer

作　　者：林少丹[1] 卢淮武[1] 谢庆生[1] 张媛媛[1] 管媚媚[1] 林仲秋[1] 

机构地区：[1]中山大学孙逸仙纪念医院妇瘤科,广州510120

出　　处：《国际妇产科学杂志》2014年第4期355-360,共6页Journal of International Obstetrics and Gynecology

摘　　要：宫旁转移是影响宫颈癌预后的重要因素。宫旁转移包括宫旁软组织受累、宫旁淋巴结转移和宫旁脉管内见癌栓。与早期宫颈癌宫旁转移相关的因素包括:年龄、临床分期、分化程度、肿瘤大小、间质浸润深度、淋巴结转移、淋巴脉管浸润(LVSI)、宫体累及、阴道累及、手术切缘、术前血清鳞状细胞抗原浓度和卵巢转移等。现普遍认为与早期宫颈癌宫旁浸润密切相关的因素包括肿瘤大小、浸润深度、淋巴结和LVSI状态。研究者们提出了一些以这4个因素为基础的早期宫颈癌宫旁转移的低危标准,包括ⅠB1期以前,肿瘤直径≤2 cm,浸润深度<5 mm或<10 mm,LVSI阴性,淋巴结阴性;可以考虑对符合低危标准的患者选择范围较小的根治术,如改良根治性切除术、单纯全子宫切除或宫颈切除术加盆腔淋巴结切除术。Parametrial involvement is one of the most important prognostic factors of cervical cancer. Parametrial involvement is defined as either malignant cell in the parametrium or tumor emboli within lymphvascular channels or lymph nodes. The factors associated with parametrial involvement of early cervical cancer are age ,stage,grade,tumor size,invasion depth,pelvic lymph node metastases,lymphvascular invasion （LVSI）,uterine involvement,vaginal involvement,the preoperative serum of squamous cell carcinoma and ovarian metastasis. It is generally believed that the most important factors associated with parametrial involvement of early cervical cancer are tumor size,invasion depth,pelvic lymph node metastases,LVSI. The researchers have proposed the criteria of the low risk for parametrial involvement include tumor size≤2 cm,invasion〈5 mm or〈10 mm,negative lymph nodes and negative lymphvascular invasion. Patients at low risk could be considered for less radical surgery such as modified radical hysterectomy or simple hysterectomy or trachelectomy with pelvic lymphadenectomy.

关 键 词：宫颈肿瘤 肿瘤转移 淋巴转移 淋巴细胞 肿瘤浸润 妇科外科手术 

分 类 号：R737.33[医药卫生—肿瘤]