早期宫颈癌FIGO分期与手术病理分期的差异性及淋巴结转移危险因素的分析？  

Analysis of differences of FIGO staging and surgical staging and risk factors of lymph node metastasis of cervical cancer

作　　者：孙瑞瑞[1] 胡尔西旦·尼牙孜[1] 赵化荣[1] 张蕾[1] 热合曼·衣明[1] 包永星[1] 

机构地区：[1]乌鲁木齐新疆医科大学第一附属医院肿瘤中心,830011

出　　处：《临床肿瘤学杂志》2015年第8期704-708,共5页Chinese Clinical Oncology

基　　金：乌鲁木齐市科学技术项目(H111313001);乌鲁木齐感染与肿瘤重点实验室(培育基地)开放课题(WIT-2013-01)

摘　　要：目的：比较宫颈癌临床分期（ FIGO分期）与手术病理分期的差异性，探讨影响淋巴结转移的危险因素。方法收集2010年1月至2014年1月在新疆医科大学第一附属医院经手术治疗的181例早期宫颈癌（ FIGO分期ⅠA∽ⅡB）患者的临床病理资料进行回顾性分析，比较FIGO分期与手术病理分期的差异，用卡方检验和Logistic回归模型分析影响淋巴结转移的危险因素。结果ⅠA、ⅠB、ⅡA、ⅡB各临床分期与手术病理分期的符合率分别为57.9％、73.6％、52.1％和39.5％，临床分期总的符合率为59.1％（107／181）。ⅠA、ⅠB、ⅡA、ⅡB各期的淋巴结转移率分别为10.5％、13.1％、27.1％和50.0％。单因素分析显示鳞状细胞癌抗原（ SCCA）、FIGO分期、肿瘤直径、新辅助化疗、肌层浸润深度、脉管内瘤栓及宫旁组织浸润与盆腔淋巴结转移有关（ P＜0.05）；多因素分析显示SCCA、FIGO分期、肌层浸润深度及脉管内瘤栓是影响宫颈癌淋巴结转移的独立危险因素，新辅助化疗可减少淋巴结的转移（ P＜0.05）。结论随着FIGO分期的升高，两种分期的符合率呈下降趋势，淋巴结转移率升高。结合临床病理因素，分析影响宫颈癌患者淋巴结转移的相关高危因素，可为制定其合理个体化的治疗方案提供依据。Objective To compare the difference of clinical staging of cervical cancer with operative pathological staging, fur.ther to explore the risk factors for lymph node metastasis. Methods The clinicopathologic parameters in 181 inpatients with Federation International of Gynecology and Obstetrics （ FIGO） stageⅠA.ⅡB cervical cancer in the First Affiliated Hospital of Xinjiang Medical U.niversity from January 2010 to January 2014 were retrospectively analyzed. The risk factors for lymph node metastasis were evaluated by the way of univariate X2 statsistic analysis and binary Logistic regression analysis. Results The coincidence rates of FIGO stagesⅠA,ⅠB,ⅡA,ⅡB with surgical stage were 57.9%, 73.6%, 52.1% and 39.5%, respectively. The overall accuracy rate of the clinical staging was 59.1% （107/181）. ⅠA, ⅠB, ⅡA, ⅡB periods of lymph node metastasis rates were 10.5%, 13.1%, 27.1% and 50.0%, respectively. Univariate analysis showed that the serum level of squamous cell carcinoma antigen （SCCA）, clinical stage, tumor size, neoadjuvant chemotherapy, deep stromal invasion, vascular invasion and uterine tissue invasion were associated with pelvic lymph node metastasis（P〈0.05）. Multivariate analysis showed that SCCA, FIGO stage, deep myometrial invasion, vascular tumor thrombus were the independent risk factor for lymph node metastasis（ P〈0.05） . Neoadjuvant chemotherapy could reduce the metastatic lymph nodes. Conclusion With the increasing FIGO stage, the lower rate of two stages in accuracy, the higher rate of lymph node metastasis. Study on risk factors of cervical cancer with lymph node metastasis can provide references for individual treatment.

关 键 词：宫颈癌 临床分期 手术病理分期 淋巴结转移 

分 类 号：R737.33[医药卫生—肿瘤]