外阴癌淋巴结转移相关因素分析

RELATIVITY ANALYSIS ON LYMPHATIC METASTASIS FACTORS OF THE VULVAR CARCINOMA

对４８例外阴鳞状细胞癌的淋巴结转移相关因素进行了临床病理分析，并应用流式细胞术（ｆｌｏｗｃｙｔｏｍｅｔｒｙＦＣＭ）对其中的３１例检测了细胞增殖活力、ＤＮＡ含量、ｒａｓＰ２１等。结果显示：发生淋巴结转移的外阴癌细胞的Ｓ％、ＰＩ和ＤＩ值显著高于未发生转移者；临床期别晚、组织分化差的外阴癌的淋巴结转移率显著增高。认为临床分期、Ｓ％、ＰＩ、ＤＩ值及组织学分级是影响外阴癌淋巴结转移的重要因素。

Objective : To study the clinicopathologic factors for lymphatic metastasis of the vulvar carcinoma. Methods : 48 cases of the vulvar carcinoma were analysed in clinicopathology. S%, PI (Prolificative Index), DI (DNA Index) and rasP 21 in 31 cases were studied using flow cytometry. Results : S%, PI and DI of the vulvar carcinoma with lymphatic metastases were 14.33%, 24.86 and 1.22 respectively, which were significantly higher than those with no lymphatic metastases. The lymphatic metastasis rates of vulvar carcinoma were 6.25% and 62.50% in clinical stage Ⅰ+Ⅱ and stage Ⅲ+Ⅳ, and were 9.09%, 34.78% and 2/3 in histologic degrees Ⅰ,Ⅱ and Ⅲ respectively. The lymphatic metastasis of vulvar carcinoma was related to clinical stage, S%, PI, DI and histologic degree. The survival rate after operation of the vulvar carcinoma with no lymphatic metastases was significantly higher than that with lymphatic metastases. Conclusions : Clinical stage, S%, PI, DI and histologic degree are important factors for the lymphatic metastasis of vulvar carcinoma.