神经侵袭与宫颈癌临床病理特征及预后的关系

Relationship between perineural invasion and clinical pathological characteristics and prognosis of cervical cancer

目的探讨宫颈癌神经侵袭(perineural invasion,PNI)与其他临床病理特征及预后的关系,为宫颈癌的术后治疗提供依据。方法回顾性分析南京鼓楼医院自2012年1月至2017年12月收治的457例宫颈癌患者的临床及病理资料,对PNI与宫颈癌患者的临床病理特征及预后进行相关性分析。结果457例患者中PNI阳性者65例,阳性率14.2%,PNI与肿瘤分期、肿块大小、浸润深度、淋巴结转移、淋巴血管间隙浸润(lymph-vascular space invasion,LVSI)相关;且合并的这些高危因素越多,PNI的发生率越高。多因素分析提示肿瘤分期、肿块大小、LVSI是PNI发生的独立风险因素。PNI阳性患者接受辅助治疗比例远高于阴性患者(92.3%vs 64.3%,P<0.001)。生存分析提示PNI是影响宫颈癌复发和生存的独立风险因素。结论PNI与宫颈癌其他临床病理因素密切相关,是宫颈癌不良预后的独立风险因素,可用于指导宫颈癌的术后辅助治疗。

Objective To investigate the relationship between perineural invasion and other clinicopathological features and prognosis of cervical cancer,and to provide evidence for postoperative treatment of cervical cancer.Methods The clinical and pathological data of 457 patients with cervical cancer admitted to Nanjing drum tower hospital from January 2012 to December 2017 were retrospectively analyzed.The correlation between PNI and clinicopathological features and prognosis of patients with cervical cancer were analyzed.Results Of the 457 patients,65 were PNI positive.The positive rate was 14.2%,PNI was associated with tumor staging,tumor size,depth of infiltration,lymph node metastasis,lymph-vascular space invasion,and the higher risk factors combined,the higher the incidence of PNI.Multivariate analysis suggested that tumor staging,mass size and LVSI were independent risk factors for the development of PNI.The proportion of PNI positive patients receiving adjuvant therapy was much higher than that of negative patients(92.3%vs 64.3%,P<0.001).Survival analysis suggests that PNI is an independent risk factor for recurrence and survival of cervical cancer.Conclusions PNI is closely related to other clinicopathological factors of cervical cancer,and is an independent risk factor for poor prognosis of cervical cancer.It can be used to guide postoperative adjuvant therapy for cervical cancer.