摘要
目的:探讨Ⅰ_(B)期宫颈癌患者淋巴结转移相关危险因素及预后。方法:回顾性分析2014—2016年间中国医学科学院肿瘤医院收治宫颈癌根治手术±术后治疗的305例Ⅰ_(B1)~Ⅰ_(B2)期患者临床资料,其中伴淋巴结转移31例。Logistic回归模型分析影响转移的因素。结果:31例患者中位随访时间36个月,2例复发转移,3年无瘤生存率为94%(29/31);1例死亡,3年总生存率为97%(30/31)。Ⅰ_(B1)期(肿瘤≤4 cm)、Ⅰ_(B2)期(肿瘤>4 cm)淋巴结转移率分别为8.2%(22/267)、24%(9/38)(P<0.01)。淋巴脉管间隙浸润(LVSI)阳性(P<0.01)及宫颈间质浸润深度>1/2(P<0.01)与Ⅰ_(B)期发生淋巴结转移相关。多因素结果显示LVSI阳性(P=0.016)为Ⅰ_(B)期宫颈癌淋巴结转移的独立危险因素。结论:Ⅰ_(B)期宫颈癌患者中肿瘤>4 cm、伴有LVSI及宫颈间质浸润深度>1/2易发生淋巴结转移且LVSI阳性为独立危险因素。Ⅰ_(B)期宫颈癌合并淋巴结转移患者,经根治性手术及术后辅助同步放化疗可以取得较好的疗效。
Objective:To investigate the risk factors and prognosis of lymph node metastasis in patients with stageⅠ_(B)cervical cancer.Methods:From April 2014 to December 2016,the clinical data of 305 patients with stageⅠ_(B1)-Ⅰ_(B2)who were admitted to Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College for radical surgery±postoperative treatment were retrospectively analyzed.Among them,31 cases with lymph node metastasis.Logistic regression model was used to analyze the influencing factors of metastasis.Results:The median follow-up time of patients with lymph node metastasis was 36 months,2 cases with recurrence and metastasis,the 3-year disease-free survival rate was 94%(29/31);1 case died,the 3-year survival rate was 97%(30/31).Logistic regression analysis showed that the lymph node metastasis rates of stage I B1(tumor size≤4 cm)or stage I B2(tumor size>4 cm)were 8.2%(22/267)or 24%(9/38),respectively,with statistical difference(P<0.01).LVSI positive(P<0.01)and cervical stromal infiltration depth>1/2(P<0.01)were associated with lymph node metastasis in stage I B.Multivariate results showed that LVSI positive(P=0.016)was an independent risk factor for lymph node metastasis in stage I_( B )cervical cancer.Conclusions:In patients with stage I_( B )cervical cancer,tumor size>4 cm,with LVSI and cervical interstitial invasion depth>1/2 are prone to lymph node metastasis,and LVSI positive is an independent risk factor.For patients with lymph node metastasis in stage I_( B )cervical cancer,radical surgery and postoperative adjuvant concurrent chemo-radiotherapy can achieve good results.
作者
梁磊磊
曾嘉
姚洪文
安菊生
黄曼妮
李晓光
张蓉
吴令英
Liang Leilei;Zeng Jia;Yao Hongwen;An Jusheng;Huang Manni;Li Xiaoguang;Zhang Rong;Wu Lingying(Department of Gynecology,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)
出处
《中华转移性肿瘤杂志》
2020年第4期274-277,共4页
Chinese Journal of Metastatic Cancer
关键词
宫颈癌
淋巴结转移
综合治疗
预后
Cervical cancer
Lymph node metastasis
Comprehensive treatment
Prognosis
作者简介
通信作者:吴令英,Email:wulingying@csco.org.cn
