宫颈鳞癌及腺癌手术患者淋巴结分布及转移的特点差异分析  

Comparison of the characteristics of lymph nodes distribution and metastasis in cervical adenocarcinoma and squamous carcinoma

作　　者：葛莉莉 叶春萍[1] 余宁珠[1] 

机构地区：[1]南京医科大学附属妇产医院,210029

出　　处：《中国妇产科临床杂志》2017年第5期395-397,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨宫颈腺癌及鳞癌手术患者盆腔淋巴结分布及转移的特点差异。方法回顾性分析569例广泛子宫切除及盆腔淋巴结清扫术宫颈癌患者的临床及病理资料。结果宫颈腺癌患者的淋巴结转移率(43.96%)明显高于鳞癌(20.30%);腺癌患者出现更高的高位淋巴结(髂总)转移(P<0.05)。腺癌患者表现出更高比例的多组转移(26.7%vs 9.05%)和双侧转移(11.2%vs 6.8%)(P<0.05)。腺癌患者有着更高的低期别转移率,ⅠB1、ⅠB2期转移率分别为43.28%、56.25%,明显高于鳞癌(P<0.05);而高期别鳞癌如ⅡA2期转移率为55.56%,与腺癌相近。结论宫颈腺癌的淋巴结转移率显著高于鳞癌,腺癌组患者发生高位转移、多站转移、双侧转移的比例高于鳞癌组,腺癌患者比鳞癌患者更易发生早期别淋巴结转移。Objective To determine the difference of the characteristics of lymph nodes distribution and metastasis between cervical adenocarcinoma and squamous carcinoma patients. Method The clinical and pathological information of 569 patients with cervical carcinoma after radical hysterectomy with pelvic lymphadenectomy were retrospectively analysed. Results There was no significant difference in lymph nodes distribution of adenocarcinoma and squamous carcinoma patients. Patients with adenocarcinoma had significant higher lymphatic metastasis rate （43.96%） than squamous Carcinoma （20.30%）. The lymph node metastasis rate of adenocarcinoma carcinoma patients in the obturator lymph node, external iliac and internal iliac lymph node ,common iliac lymph node were 31.89%, 39.65%, 9.48% respectively, the rate of squamous carcinoma patients were 13.47%, 10.59%, 3.7% respectively. Adenocarcinoma group had higher proportion in upper lymphatic metastasis（common iliac lymph node）, multi-site lymphatic metastasis（26.7% vs 9.05%） and bilateral lymphatic metastasis （11.2% vs 6.8%）, （P 〈 0.05） . The lymph node metastasis rate of adenocarcinoma patients with stage I B1 （43.28%） and I B2 （56.25%）were higher than squamous carcinoma patients, （P 〈 0.05）, but the rate of adenocarcinoma patients with stage I1 A2 （55.56%） was similar to squamous carcinoma. Conclusions Patients with adenocarcinoma had significant higher rate of lymphatic metastasis. Including upper abdominal, multi-site or bilateral lymphatic metastasis, Early-stage metastasis.

关 键 词：宫颈腺癌 淋巴结 转移 

分 类 号：R737.33[医药卫生—肿瘤]