摘要
目的探讨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。方法回顾性分析1010例行手术治疗的ⅠA2~ⅡB期宫颈癌患者的临床资料,分析临床病理特征及盆腔淋巴结转移的危险因素,采用X^(2)检验及logistic回归分析。结果ⅠA2~ⅡB期宫颈癌发病高峰年龄为40~49岁,临床表现以接触性流血(45.15%)、不规则阴道流血(27.52%)多见,避孕方式以未避孕(38.21%)多见,首次症状出现距就诊中位时间3.25个月,四分位数时间(1.23,10.72)个月。ⅠA2~ⅡB期宫颈癌盆腔淋巴结转移率为12.38%。单因素分析表明,盆腔淋巴结转移与临床分期、肿瘤直径、病理类型、组织学分级、脉管浸润、间质浸润深度、宫旁浸润、累及阴道等因素有关(P<0.05)。多因素分析表明,肿瘤直径>4 cm(OR=1.853)、特殊病理类型宫颈癌(OR=2.921)、组织学分级(OR=0.592)、间质浸润深度>1/2全层(OR=3.674)、脉管浸润阳性(OR=4.156)、肿瘤累及阴道(OR=2.456)是盆腔淋巴结转移的独立危险因素。结论ⅠA2~ⅡB期宫颈癌发病呈年轻化趋势,肿瘤直径>4 cm、组织学分级越高、特殊病理类型宫颈癌、间质浸润深度>1/2、肿瘤累及阴道、脉管浸润更易发生盆腔淋巴结转移,应规范盆腔淋巴结切除术。
Objective To investigate the clinicopathologic characteristics of cervical cancer and the risk factors of pelvic lymph nodes metastasis(PLNM).Methods Clinical data of 1010 patients with StageⅠA2 toⅡB cervical cancer treated with surgery were retrospectively studied.The clinicopathologic characteristics and PLNM condition of each patient were abstracted,and the influencing factors of PLNM were analyzed by X^(2) and logistic regression analysis.Results The peak age of cervical cancer with StageⅠA2 toⅡB was 40-49 years;and major clinical manifestations were contact bleeding and irregular vaginal bleeding,accounting for 45.15%and 27.5%,respectively.The commonest contraceptive method was non-contraceptive(38.21%),and the mean time from the appearance of primary symptoms to seeking for medical advice was 8.32±15.06 months.The rate of PLNM was 12.38%in the 1010 patients with cervical cancer.The univariate analysis suggested that clinical stage,tumor diameter,pathological type,histological grade,vascular invasion,depth of interstitial invasion,parametrical involvement and vagina involvement were significantly associated with PLNM(P<0.05).The multivariate analysis suggested tumor diameter r>4 cm(OR=1.853),special pathology types(OR=2.921),high histological grade(OR=0.592),depth of interstitial invasion>1/2 layer(OR=3.674),vascular invasion(OR=4.156)and vagina involvement(OR=2.456)were the independent risk factors of PLNM.Conclusion The trend of cervical cancer is becoming younger,patients are more likely to be complicated with PLNM if with tumor diameter over 4 cm,higher histological grade,special pathology cervical cancer,depth of interstitial invasion>1/2 layer,positive vagina involvement and positive vascular invasion.
作者
何路路
辜佳婷
罗喜平
HE Lu-lu;GU Jia-ting;LUO Xi-ping(Department of Gynaecology,Guangdong Women and Children Hospital of Guangzhou Medical University,Guangzhou 510010,Guangdong,China)
出处
《广东医学》
CAS
2021年第6期666-670,共5页
Guangdong Medical Journal
基金
广州市科技计划项目(202002030174)
广东省科技计划项目(2017ZC0317)。
关键词
宫颈癌
临床病理特征
淋巴结转移
危险因素
cervical cancer
clinicopathologic characteristics
pelvic lymph node metastasis
risk factors
