术前行放疗增敏的Ⅰ_(B2)～Ⅱ_A期宫颈癌患者盆腔淋巴结转移情况的临床分析

Clinical Analysis of Pelvic Lymph Node Metastasis in Patients with Stage Ⅰ_(B2)～Ⅱ_A Cervical Cancer Treated by Pre-operative Sensitivity Enhancement of Radiotherapy

目的分析术前给予放疗增敏的ⅠB2～ⅡA期宫颈癌患者的盆腔淋巴结转移情况,探讨淋巴结转移规律、淋巴结转移与临床病理特征的关系及放疗增敏的临床意义。方法ⅠB2～ⅡA期的宫颈癌患者64例,术前给予放疗增敏后行广泛子宫切除术及盆腔淋巴结切除术。根据病理结果记录淋巴结剔除个数及淋巴结转移的部位,计算淋巴结转移率。分析盆腔淋巴结转移与临床病理特征的关系。结果盆腔淋巴结转移8例,转移率为12.50%。术前行放疗增敏的盆腔淋巴结转移与患者年龄、FIGO分期、分化程度及组织类型无关(P>0.05)。8例有淋巴结转移的患者中,仅1组淋巴结转移的6例(75.0%),其分布为闭孔淋巴结4例(66.7%),髂内淋巴结1例(16.7%),髂外淋巴结1例(16.7%);同时有2组淋巴结转移的1例,为闭孔及髂内淋巴结;同时有4组淋巴结转移的1例,为闭孔、髂内、髂外及腹股沟深淋巴结。结论术前行放疗增敏的ⅠB2～ⅡA期宫颈癌患者中闭孔淋巴结是最常见的转移部位,其次是髂内、髂外淋巴结。术前给予放疗增敏可能降低宫颈癌患者的盆腔淋巴结转移率。

Objective To analyze the principles and its clinical significance of pelvic lymph node metastasis in patients with stageⅠB2～ⅡAcervical cancer treated by sensitivity enhancement of radiotherapy.Methods Sixty-four patients with stageⅠB2～ⅡA cervical cancer received sensitivity enhancement of radiotherapy before radical hysterectomy and pelvic lymph node dissection.According to the pathological results,lymph node metastasis sites and metastasis rate were analyzed.Results Eight cases had lymph node metastases（12.5%） Pelvic lymph node metastases had no relationship with patientsage,FIGO stage,the degree of differentiation or pathological types （P 〉 0.05）. Among 8 cases, only one group of lymph node metastasis had 6 cases（75.0% ）, among which 4 cases were obtumtor lymph nodes（66.7% ）, 1 case was internal iliac lymph node（16.67%）, and 1 case was external iliac lymph node（16.7%）. Two-group lymph node metastasis had 1 case,which was internal obturator and iliac lymph node; 4-group lymph node metastasis at the same time hod 1 case, which were obtumtor-intemal iliac/ external iliac-inguinal lymph nodes. Conclusion Obturator lymph node was the most common metastasis site in patients with stage Ⅰ82～ⅡA cervical cancer after sensitivity enhancement of radiotherapy, followed by internal iliac and external iliac lymph node. Pre-operative sensitivity enhancement of radiotherapy for cervical cancer patients may reduce the rate of pelvic lymph node metastasis.