Ⅰ～ⅡA2期宫颈癌淋巴结转移高危因素及对预后的影响  

High risk factors of stage Ⅰ～ⅡA2 cervical cancer lymph node metastasis and their influence on prognosis

作　　者：吴乾凤[1,2] 高国兰[2] 孔为民[1] 

机构地区：[1]首都医科大学附属北京妇产医院妇瘤科,100006 [2]航空总医院妇科

出　　处：《中国妇产科临床杂志》2016年第5期407-409,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨宫颈癌盆腔淋巴结转移的高危因素及对预后的影响,提高生存率。方法回顾分析1995年1月至2011年6月在首都医科大学附属北京妇产医院经根治性手术治疗550例Ⅰ~ⅡA2期宫颈癌,盆腔淋巴结转移的相关危险因素及预后。结果 64例宫颈癌有盆腔淋巴结转移,无淋巴结转移者5年生存率92.2%,有转移者5年生存率51.6%（P〈0.05）。单因素分析,淋巴结转移与临床分期、组织学分级、肿瘤最大径线、宫颈深间质浸润、宫旁浸润、脉管间隙浸润相关（P〈0.05）;宫旁组织浸润、转移淋巴结部位、阴道切缘状况、转移淋巴结数量、转移淋巴结组数,是有盆腔淋巴结转移宫颈癌预后的重要因素（P〈0.05）。多因素分析宫颈深间质浸润（P=0.001）和脉管间隙浸润（P=0.000）是影响宫颈癌淋巴结转移的独立危险因素;转移淋巴结组数2（P=0.000）是影响有淋巴结转移宫颈癌预后的独立危险因素。结论宫颈深间质浸润、脉管间隙浸润是影响宫颈癌盆腔淋巴结转移的独立高危因素;转移淋巴结组数≥2是有淋巴结转移宫颈癌影响预后的独立危险因素。Objective To investigate the high risk factors of cervical cancer lymph node metastasis and their influence on prognosis, in order to increase the survival rate. Methods Retrospective analysis of the risk factors of cervical cancer lymph node metastasis and prognosis of 550 cases of stage Ⅰ~ ⅡA2 cervical cancer who treated at Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University between January 1995 and June 2011 recruited in this retrospective study. The risk factors of lymph node metastasis and the prognosis of patients were analyzed. Results 64 patients were confirmed with pelvic lymph node metastasis. The 5-year survival rate was 92.2% in patients with no lymph node metastasis and 51.6% in those with lymph node metastasis（P〈0.05）. Univariate analysis showed that lymph node metastasis was related to clinical stage, histological grade, maximum tumor diameter line, deep cervical stromal invasion, parametrial invasion and vascular space invasion（P〈0.05）. Major factors of cervical carcinoma with lymph node metastasis included parametrial tissue infiltration, the sites of lymph node metastasis, vaginal margin status, the number of metastatic lymph node and the group of metastasis lymph node（P〈0.05）. Multivarible analysis showed that deep cervical stromal invasion（P=0.001） and vascular space invasion（P=0.000） were the independent risk factors that influence the lymph node metastasis of cervical cancer. The groups of metastatic lymph nodes≥2（P=0.000） was the independent risk factor affecting the prognosis of lymph node metastasis of cervical cancer. Conclusions Deep cervical stromal invasion（P=0.001） and vascular space invasion（P=0.000） are the independent predictive factors that influence the lymph node metastasis of cervical cancer. The groups of metastatic lymph nodes ≥2 is the independent predictive factor affecting the prognosis of lymph node metastasis of cervical cancer.

关 键 词：宫颈癌 转移 盆腔淋巴结 高危因素 预后 

分 类 号：R737.33[医药卫生—肿瘤]