Ⅰ～Ⅱa期宫颈癌淋巴结转移的相关因素分析  

The risk factors of lymphatic metastasis in stage Ⅰ- Ⅱa cervical cancer

作　　者：刘山[1] 张映红[1] 魏巍[1] 吴小华[2] 陈鸣之[2] 

机构地区：[1]安徽省铜陵市妇幼保健院妇科,244000 [2]复旦大学附属肿瘤医院妇瘤科,上海市200030

出　　处：《中华全科医学》2015年第9期1468-1469,1476,共3页Chinese Journal of General Practice

摘　　要：目的探讨早期宫颈癌盆腹腔淋巴结转移的相关影响因素。方法回顾性分析220例早期宫颈癌根治术后患者的临床病理资料。47例(21.4%)病理发生盆腹腔淋巴结转移为研究组,173例(78.6%)病理未发生盆腹腔淋巴结转移为对照组,比较2组年龄、临床分期、肿瘤直径、组织学类型、肿瘤类型、脉管内瘤栓、深肌层浸润及术前辅助治疗;比较淋巴结数≥20枚/例组与<20枚/例组盆腹腔淋巴结转移率。结果研究组脉管内瘤栓阳性者33例(70.2%),对照组24例(13.9%),2组差异有统计学意义(P<0.05);宫颈肌层癌浸润深度>2/3者21例(44.7%),对照组21例(12.1%),2组差异有统计学意义(P<0.05);2组肿瘤直径(≥4 cm)、内生型肿瘤与盆腔淋巴结转移有关(P<0.05),而年龄、临床分期、组织学类型、术前辅助治疗与淋巴结转移无关(P>0.05)。清除淋巴结数≥20枚/例组中转移阳性率29.0%,而清除淋巴结数<20枚/例组中转移阳性率15.7%,差异有统计学意义(P<0.05)。结论脉管内瘤栓阳、宫颈肌层癌浸润深度>2/3、肿瘤直径≥4 cm和内生型肿瘤是宫颈癌患者淋巴结转移的危险因素,淋巴结清除数目不足20个影响术后病理淋巴结阳性率。Objective To explore the risk factors in stage Ⅰ～Ⅱa cervical cancer cases with pelvic lymphatic metas- tas. Methods The clinial pathological data of 220 cases with early stage cervical cancer undergone extensive hysterecto- my and pelvic lymphadenectomy were retrospectively analyzed. Abdominal lymphatic metastasis were found in 47 patients （21.4%） as study group,and were not found in 173 patients（78. 6% ）as control group. The age,clinical stage,tumor size, histological classification, lymphovascular invasion-positive, deep stromal invasion, grading and preoperative adjuvant therapy of two groups were compared. Comparison of lymph node metastasis rate between the lymph node number（≥20） cases and the lymph node number（ 〈 20）eases was conducted. Results In the study group,33 cases （70. 2% ）were lym- phovascular invasion-positive; while in the control group, 24 cases （ 13. 9% ） were negative, difference was statistically sig- nificant（ P 〈 O. 05）;there are 21 cases（44. 7% ） of deep stromal invasion （ 〉 2/3）, while in the control group there are 21 cases （ 12. 1% ）, difference was statistically significant（ P 〈 0. 05 ） ;The pelvic lymphatie metastasis was not associated with the age, clinical stage, tumor size, histological classification, grading and preoperative adjuvant therapy （ P 〉 0. 05 ）. In the lymph node number（20） cases,the positive rate of lymph node metastasis was 29. 0% ,while in the lymph node number（ 〈 20）cases,the positive rate was 15.7%, there was significant difference（ P 〈 0. 05 ）. Conclusion Lymphovas- cular invasion-positive and deep stromal invasion（ 〉 2/3 ） were risk factors of cervical cancer patients with pelvie lymph node metastasis. Lymph node number less than 20 may reduce the metastatic positive rate of the lymph node pathology af- ter operation.

关 键 词：宫颈癌 淋巴结转移 相关因素 

分 类 号：R737.33[医药卫生—肿瘤] R730.21[医药卫生—临床医学]