早期宫颈癌淋巴结转移危险因素分析

Analysis of Risk Factors of Lymph Node Metastases in Early Cervical Cancer

目的:研究早期宫颈癌淋巴结转移的危险因素,建立危险分层指数为个体化治疗提供依据。方法:采用单因素及多因素Logistic回归分析,对我院355例ⅠA-ⅡA期宫颈癌手术患者的临床病理资料进行回顾性分析。结果:355例宫颈癌患者盆腔淋巴结转移率为27.0%;多因素分析显示Figo分期(OR=1.90),浸润深度(OR=7.56)和肿瘤直径(OR=2.51)是淋巴结转移的危险因素;当逐一增加这些危险因素时,危险分层指数显示淋巴结转移危险度Ⅰ期为5%-50%,Ⅱ期为9%-65%。结论:在低危的Ⅰ期和高危的Ⅱ期宫颈癌中淋巴结转移风险存在相当大的跨度,使用危险分层模型能指导个体化治疗。

Objective： To investigate the risk factors for lymph node metastases and to construct a risk stratification index to provide the basis for making an individual therapy for the patients with cervical cancer. Methods： The clinicopathologie parameters in 355 patients with stage ⅠA-ⅡA cervical carcinoma were retrospectively analyzed. Uni- and multi-variate logistic regression analyses were used to calculate the predictive power of each risk factor. Results： Of the 355 patients with ⅠA-ⅡA cervical carcinoma, the rate of pelvic lymph node metastases was 27.0%. FIGO stage （OR=I. 90）, depth of cervical stromal invasion（OR=7.56） and tumor diameters （OR= 2.56） were identified as significant risk factors for lymph node metastases in the multivariate analysis. The risk stratification index showed the risk for lymph node metastases gradually increasing from 5% to 50% and 9% to 65% in Ⅰ and Ⅱ stage cancers respectively, when adding the risk factors one by one. Conclusion： There is a considerable span in the risk for lymph node metastases between low risk Ⅰ and high risk Ⅱ stage cervical cancer. Using the risk stratification-model can provide references for individualized treatment.