摘要
目的调查分析ⅠA2~ⅡA2期宫颈癌主韧带浸润情况,探寻影响早期宫颈癌主韧带浸润的高危临床病理因素。方法调取5家医院2004年1月1日至2014年12月31日宫颈癌行手术治疗患者2 982例的临床、病理资料进行回顾性研究。结果 （1）纳入符合研究条件的患者855例,主韧带浸润20例（2.3%）。ⅠA2期无主韧带浸润发生,ⅠB1期主韧带浸润率1.7%、ⅠB2期1.2%、ⅡA1期5.7%、ⅡA2期2.9%,随宫颈癌国际妇产科联盟（FIGO）分期增加,主韧带浸润率无明显增加（P=0.269）。（2）ⅠA2~ⅡA2期宫颈癌左、右侧主韧带浸润率相比较差异无统计学意义（P=1.000）;FIGO分期不同的左侧主韧带浸润率差异无统计学意义（P=0.286）,而右侧主韧带浸润率则差异有统计学意义（P=0.005）,其中ⅡA1期最高（4.3%）。（3）单因素分析发现淋巴脉管浸润、宫颈间质浸润深度、盆腔淋巴结转移、宫体浸润、阴道穹窿浸润是主韧带浸润的危险因素（P〈0.1）;多因素分析确定宫体浸润（OR=11.858）、盆腔淋巴结转移（OR=6.359）及阴道穹窿浸润（OR=6.012）为主韧带浸润的危险因素（P〈0.05）。结论早期宫颈癌主韧带浸润的发生率低,宫体浸润、盆腔淋巴结转移、阴道穹窿浸润是影响ⅠA2~ⅡA2期宫颈癌主韧带浸润的危险因素。
Objective To investigate the invasion situation of cardinal ligaments（CL）in stage ⅠA2-ⅡA2cervical cancer and to find the high risk clinicopathological factors affecting its invasion.Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5hospitals from January 2004 to December 2014.Results（1）Totally 855 cases according with the research condition were included.The CL invasion was found in 20cases（2.3%）.No CL invasion occurred in the stageⅠA2,the CL invasion rate in the stageⅠB1was 1.7%,in the stageⅠB2was1.2%,in the stageⅡA1was 5.7% and in the stageⅡA2was 2.9%.With the increase of FIGO staging,the CL invasion rate had no significant increase（P=0.269）.（2）The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2-ⅡA2（P=1.000）.And the invasion rate of the left CL with different FIGO stages had no statistical difference（P=0.286）,while the right one had statistical difference（P=0.005）,in which the highest was in the stageⅡA1（4.3%）.（3）The univariate analysis found that lymph-vascular invasion,cervical stroma infiltration depth,pelvic lymph node metastasis,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion（P〈0.01）;the further multivariate analysis determined that the invasion of uterine body（OR=11.858）,pelvic lymph node metastasis（OR=6.359,）,vaginal fornix infiltration（OR=6.012,）were the risk factors for CL invasion（P〈0.05）.Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low.The invasion of uterine body,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2-ⅡA2cervical cancer.
出处
《重庆医学》
CAS
北大核心
2016年第12期1641-1644,共4页
Chongqing medicine
基金
国家科技支撑计划项目(2014BAI05B03)
国家自然科学基金资助项目(81272585
61190120)
广州市科技计划健康医疗协同创新重大专项(201508020264)
关键词
宫颈肿瘤
主韧带
子宫切除术
uterine cervical neoplasms
cardinal ligament
hysterectomy
