宫颈癌患者淋巴结转移的影响因素分析

Analysis of Factors Affecting Lymph Node Metastasis of Cervical Cancer

目的探讨宫颈癌患者淋巴结转移的分布规律、高危因素。方法选取均经活检或手术病理证实的71例宫颈癌患者为研究对象,对影响淋巴结转移的因素采用Logistic多因素回归分析。结果 71例宫颈癌患者中有14例患者发生淋巴结转移,转移率为19.7%;单因素分析结果显示肿瘤直径、SCCAg水平、FIGO分期、病理分型、肌层浸润深度、脉管侵犯、分化程度与淋巴结转移相关(P<0.05),而年龄、手术切缘与淋巴结转移不具相关性(P>0.05);Logistic多因素回归分析结果显示治疗前SCCAg水平、脉管侵犯、FIGO分期、肌层浸润深度以及分化程度5个因素是淋巴结转移的独立危险因素。结论治疗前SCCAg>4 ng/ml、宫颈浸润深度≥肌层1/2、脉管侵犯、FIGO分期较晚及细胞分化程度较高是宫颈癌盆腔淋巴结转移的主要危险因素。

Objective To study the distributional features and high-risk factors of lymph node metastasis of cervical cancer. Methods 71 cases of cervical cancer patients confirmed by biopsy or surgical pathology were selected as the research object,and the logistic muhifactor regression analysis was used to analyze the influencing factors of lymph node metastasis. Results Among 71 cervical cancer patients, 14 cases had lymph node metastases, the metastasis rate was 19.7% ; Single factor analysis showed that tumor diameter, SCCAg level, FIGO stage, pathological type, muscularis infiltrating depth, vascular invasion, differenti- ation degree were related to lymph node metastasis（ P 〈 O. 05 ）, while there was no correlation among age, surgical cut edge and lymph node metastasis（P 〉 0.05 ）; Logistic multifactor regression analysis showed that SCCAg level, vascular invasion, FIGO staging, muscularis infiltrating depth and differentiation degree were 5 independent risk factors of lymph node metastasis before the treatment. Conclusion Before treatment, SCCAg 〉 4 ng/ml, the cervical infiltration depth equal or greater than 1/2 of muscular layer, vascular invasion,late FIGO staging and high degree of cell differentiation are the major risk factor of cervical cancer pelvic lymph node metastasis.