淋巴结转移对中晚期子宫颈癌患者预后影响研究  

Effect of lymph node metastasis on prognosis of patients with advanced cervical cancer

作　　者：胡鹏 王宏兵 HU Peng;WANG Hong-bing(Department of Gynecological Oncology,Hubei Cancer Hospital,Wuhan 430070 China)

机构地区：[1]湖北省肿瘤医院妇瘤科,湖北武汉430070

出　　处：《中国实用妇科与产科杂志》2022年第7期748-751,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：湖北省卫健委科研项目(WJ2019H134)。

摘　　要：目的探讨淋巴结转移对中晚期子宫颈癌预后的影响,并分析其影响因素。方法对2013年1月至2016年10月在湖北省肿瘤医院妇瘤科就诊治疗的90例中晚期(ⅡB~ⅣB期)子宫颈癌伴盆腔和(或)腹主动脉旁淋巴结转移患者的临床和随访资料进行回顾性分析。随访截止日期为2019年11月30日。生存分析采用KaplanMeier法并行Log-rank检验。结果(1)盆腔淋巴结转移和腹主动旁淋巴结转移患者的3年总体生存率(overall survival,OS)比较,差异有统计学意义(62.9%vs.35.0%,P=0.027)。(2)淋巴结转移数目<3个和淋巴结转移数目≥3个患者的3年OS比较,差异有统计学意义(69.8%vs.37.8%,P=0.003)。(3)淋巴结转移最大短径<1.5cm和淋巴结转移最大短径≥1.5 cm患者的3年OS比较,差异有统计学意义(68.8%vs.42.9%,P=0.013)。(4)普通放疗和调强放疗患者的3年OS比较,差异有统计学意义(37.5%vs.62.2%,P=0.007)。结论腹主动脉旁淋巴结转移、淋巴结转移数目≥3个、淋巴结转移最大短径≥1.5cm是中晚期子宫颈癌淋巴结转移患者预后不良的因素,放疗方式建议行调强放疗。Objective To analyze the effect of lymph node metastasis on the prognosis of advanced cervical cancer,and to explore the influencing factors.Methods The clinical and follow-up data of 90 patients were retrospectively studied.They were all diagnosed with advanced cervical cancer(stageⅡB~ⅣB)with pelvic and(or)para-aortic lymph nodes(PALN)metastasis,and were treated in our hospital from Jan.2013 to Oct.2016.The deadline of follow-up was Nov.30,2019.Survival analysis was performed by using Kaplan-Meier method and Log-rank test.Results(1)The differences in 3-year overall survival(OS)between Patients with pelvic lymph nodes metastasis and patients with paraaortic lymph nodes metastasis were statistically significant(62.9%vs.35.0%,P=0.027).(2)The differences in 3-year OS between Patients with<3 positive lymph nodes and patients with≥3 positive lymph nodes were statistically significant(69.8%vs.37.8%,P=0.003).(3)The differences in 3-year OS between Patients with shortest axis lymph node size of<1.5 cm and patients with shortest axis lymph node size of≥1.5 cm were statistically significant(68.8%vs.42.9%,P=0.013).(4)The differences in 3-year OS between Patients with conventional radiotherapy and patients with IMRT/IGRT were statistically significant(37.5%vs.62.2%,P=0.007).Conclusion Para-aortic lymph nodes(PALN)metastasis,≥3 positive lymph nodes,shortest axis lymph node size of≥1.5 cm are factors for poor prognosis of advanced cervical cancer with lympth node metastasis.Intensity modulated IMRT/IGRT is recommended as the radiotherapy methods of advanced cervical cancer.

关 键 词：淋巴结转移 放疗 中晚期子宫颈癌 预后 

分 类 号：R737.3[医药卫生—肿瘤]