宫颈鳞癌和宫颈腺癌卵巢转移比较及危险因素分析

Comparison on ovarian metastasis of squamous cell carcinoma and adenocarcinoma of uterine cervix and analysis on the correlated dangerous factors

【目的】探讨宫颈鳞癌与宫颈腺癌卵巢转移的特点及高危因素。【方法】分析2004年1月-2010年1月625例术后病理诊断为宫颈鳞癌和腺癌患者的临床病理资料,其中鳞癌355例,平均年龄50.5岁;腺癌270例,平均年龄49.5岁。比较宫颈鳞癌和腺癌卵巢转移发生率及患者年龄、肥胖、月经情况、组织学类型、分化程度、宫旁浸润、子宫内膜受侵、肿瘤大小、临床分期、淋巴结转移与卵巢转移之间的关系。【结果】625例患者中22例(3.5%)有卵巢转移,宫颈腺癌卵巢转移发生率(17/270,6.3%)显著高于宫颈鳞癌(5/355,1.4%,P<0.01)。41～50岁、绝经前、Ⅱb、肿瘤直径>4 cm的宫颈腺癌患者卵巢转移发生率均显著高于宫颈鳞癌。宫颈低分化腺癌卵巢转移率高于宫颈低分化鳞癌(P<0.05)。子宫内膜浸润、淋巴结转移与宫颈鳞癌及腺癌卵巢转移均相关,而宫旁浸润与宫颈腺癌卵巢转移相关。临床分期IIb期是宫颈鳞癌卵巢转移的独立显著变量,肿瘤超过4 cm是宫颈腺癌卵巢转移的独立显著变量。【结论】宫颈腺癌卵巢转移发生率高于宫颈鳞癌,宫颈鳞癌卵巢转移发生率与临床分期密切相关,而宫颈腺癌卵巢转移与肿瘤大小密切相关。

【Objective】 To explore the ovarian mentastasis and the correlated dangerous factors in patients with squamous cell carcinoma and adenocarcinoma of the uterine cervix.【Methods】 625 patients with uterine cervix carcinoma including 355 with invasive squamous cell carcinoma and 270 with adenocarcinoma underwent radical hysterectomy from January 2004 to January 2010 were studied.The relation between patients’ age,menopausal state,presence or absence of obesity,clinical stage of disease,histological subtype,presence or absence of pathological parametrial invasion,vaginal invasion,lymph node metastasis,endometrial invasion and ovarian metastasis were observed.【Results】 Ovarian metastasis was found in 22 patients.The number of ovarian metastasis rate in patients with adenocarcinoma（17/270,6.3%）was significantly higher than that of patients with squamous cell carcinoma（5/355,1.4%,P〈0.01）.The number of patients whose age was from 41 to 50 years old with ovarian metastasis from adenocarcinoma was significantly higher than that of patients with ovarian metastasis from squamous cell carcinoma.The incidence of ovarian metastasis of adenocarcinoma patients in the premenopausal state,in the large tumor maximum diameter greater than 4 cm or in pelvic lymph node metastasis was also significantly higher.The incidence of pathological vaginal invasion of squamous cell carcinoma was significantly higher than that of adenocarcinoma,while the incidence of endometrial invasion of squamous cell carcinoma was significantly lower.Clinical stage II was a significant variable of squamous cell carcinoma,and more than 4 cm tumor size was significant in adenocarcinoma.【Conclusion】 The incidence of ovarian metastasis of adenocarcinoma of the uterine cervix is significantly higher than that of squamous cell carcinoma.The incidence of adenocarcinoma is associated more closely with tumor size than clinical stage,whereas it is more associated with clinical stage in squamous cell carcinoma.