阴茎鳞癌组织学亚型与腹股沟淋巴结转移的相关性分析  

The relationship between histopathological classification and probability of inguinal lymph node metastases in penile cancer

作　　者：王进有[1] 于德新[1] 谢栋栋[1] 王毅[1] 毕良宽[1] 张涛[1] 丁德茂[1] 

机构地区：[1]安徽医科大学第二附属医院泌尿外科,安徽合肥230601

出　　处：《现代泌尿外科杂志》2016年第11期834-837,共4页Journal of Modern Urology

基　　金：安徽省自然科学基金(No.1608085QH173)

摘　　要：目的探讨不同组织学亚型阴茎鳞癌和腹股沟淋巴结转移概率的关系。方法回顾183例行腹股沟淋巴结清扫的阴茎癌患者资料,按照WHO 2016年阴茎癌分型标准复习病理切片并重新分型,同时收集患者年龄、肿瘤分期、临床区域淋巴结分期、脉管栓塞以及是否神经侵犯。对可能影响腹股沟淋巴结转移的因子进行单因素和Logistic多因素回归分析。结果 9例乳头状癌中1例(11.1%)、20例疣状癌中1例(5.0%)出现腹股沟淋巴结转移,22例疣性癌中7例(31.8%)及63例(54.3%)经典鳞癌被证实淋巴结受累;所有腺鳞癌、肉瘤样癌及75%的基底细胞癌发生淋巴结转移,组间差异有统计学意义(P<0.000)。然而多因素分析显示组织学亚型并非腹股沟淋巴结转移的独立预测因子。结论阴茎鳞癌不同亚型与区域性淋巴结转移关系密切,病理分型为低危险组建议观察随访;高危险组患者最好行预防性双侧腹股沟淋巴结清扫术;疣性鳞癌和经典型鳞癌患者需结合其他预测因子和临床检查制定合适的诊疗计划。Objective To investigate the relationship between histopathological classification and the probability of ingui- nal lymph node metastases （LNM） in patients with penile cancer. Methods Clinical data of 183 patients who underwent in- guinal lymph node dissection for penile cancer were retrospectively assessed. Primary lesions were re-evaluated according to the 2016 WHO histopathological clissification. The clinicopathological factors in the medical records were retrieved, including age, pathological T stage, clinical stage, lymphovascular invasion and so on. A multivariate Cox proportional hazards model was used to explore the risk factors of inguinal lymph node metastases. Results LNM occurred in 1 （11.1~） of 9 cases of papilla- ry carcinoma and in 1 （5.0%） of 20 cases of verrucous carcinoma. Seven （31.8%） o{ 22 cases of condylomatous warty carcinoma and 63 （54.3~） cases of typical squamous cell carcinoma developed LNM. All sarcomatoid andadenousquamous carcinomas and 75% of basaloid carcinoma cases developed LNM. The differences among these groups were significant （P〈O. 000）. However, in multivariate analysis, the histological subtypes were not significantly associated with LNM. Oonclusions The histopathologi- cal classification was significant predictor for LNM in univariate analysis, and it can be used to guide clinical practise. Follow- up observation is recommended for the low risk group, and prophylactic inguinal lymphadenectomy is recommended for the high-risk group, while the intermediate group requires a combination of other predictors to work out a plan.

关 键 词：阴茎肿瘤 组织病理学分型 分期 浸润深度 淋巴结转移 

分 类 号：R737[医药卫生—肿瘤]