1011例子宫颈癌临床病理特征及盆腔淋巴结转移危险因素分析  

The Analysis of the Clinicopathologic Characteristics and the Risk Factors of Pelvic Lymph Node Metastasis in 1011 Cases of Cervical Cancer

作　　者：余慧 张涛红 曾宪玲[1] 熊莉莉 李涵 安瑞芳[1] YU Hui;ZHANG Taohong;ZENG Xianling(The First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an Shanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院,陕西西安710061

出　　处：《实用妇产科杂志》2018年第10期759-762,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨子宫颈癌的临床病理特征和影响盆腔淋巴结转移的危险因素,为制定合理手术范围提供依据。方法:收集并分析1011例子宫颈癌患者的临床和术后病理资料,采用单因素和多因素Logistic回归分析临床病理特征及盆腔淋巴结转移的危险因素。结果:患者发病年龄为24～77岁,孕次为0～10次,产次为0～9次,绝经年龄为30～60岁。临床表现以接触性出血(40. 75%)及阴道不规则流血(38. 87%)多见。1011例子宫颈癌患者盆腔淋巴结阳性率14. 84%(150/1011)。单因素分析结果显示:FIGO分期、肿瘤直径、肿瘤浸润宫颈深度、肿瘤细胞分化程度、宫旁浸润、脉管浸润、切缘阳性、累及阴道以及累及子宫下段与盆腔淋巴结转移有关(P<0. 05); Logistic多因素回归分析显示:肿瘤直径>2 cm(OR=1. 671)、肿瘤浸润深度> 1/2子宫颈全层(OR=4. 452)、宫旁浸润(OR=2. 983)、脉管浸润(OR=4. 306)、肿瘤累及子宫下段(OR=1. 831)是盆腔淋巴结转移的独立危险因素。结论:肿瘤直径>2 cm、肿瘤浸润深度>1/2子宫颈全层、宫旁浸润、脉管浸润、肿瘤累及子宫下段的患者更易发生盆腔淋巴结转移,应规范盆腔淋巴结切除术。Objective： To explore the clinicopathologic characteristics of cervical cancer and the risk factors of pelvic lymph nodes metastasis,and to provide evidence for the appropriate operation scope. Methods： The clinical and pathological data of 1011 patients with cervical cancer was collected and analyzed.Uni-and multi-variate logistic regression analysis were performed to analyze the clinicopathologic characteristics and the risk factors of pelvic lymph node metastasis.Results： The patients were between 24-77 years old and with 0-10 pregnancies,0-9 deliveries,and the age of menopause between 30-60 years old.The most common clinical manifestations were contact bleeding and irregular vaginal bleeding,accounting for 40. 75% and 38. 87% respectively.The rate of pelvic lymph node metastasis was 14. 84% in the 1011 patients with cervical cancer.The uni-variate logistic regression analysis showed that the FIGO stage,the diameter of tumor,the depth of cervical invasion,the differentiation degree of tumor,the parametrical involvement,the vascular invasion,positive cutting edge,vagina involvement and the lower uterine segment involvement were relevant to pelvic lymph node metastasis（ P〈0. 05）.The multivariate logistic regression analysis showed that the tumor diameter〉 2 cm（ OR = 1. 671）,the depth of cervical invasion 〉 1/2 layer（ OR = 4. 452）,parametrical involvement（ OR = 2. 983）,vascular invasion（ OR = 4. 306）,and the lower uterine segment involvement（ OR = 1. 831） were independent risk factors of pelvic lymph node metastases.Conclusions： Patients are more likely to be complicated with pelvic lymph node metastasis if with a tumor size greater than 2 cm,the depth of cervical invasion1/2 layer,positive parametrical involvement,positive vascular invasion and the lower uterine segment involvement.These patients should accept the standardized pelvic lymphadenectomy.

关 键 词：子宫颈癌 临床病理特征 盆腔淋巴结转移 危险因素 

分 类 号：R737.33[医药卫生—肿瘤]