宫颈癌神经侵袭与其预后的相关性分析

Correlation analysis of perineural invasion and prognosis of cervical cancer

目的探讨宫颈癌神经侵袭（PNI）与宫颈癌预后的相关性。方法回顾性分析青岛市市立医院2002~2012年接受根治性子宫全切术＋盆腔淋巴结清扫术治疗的165例早期（ⅠA2～ⅡA2期）宫颈癌患者的临床资料，研究神经侵袭与宫颈癌临床病理参数的关系及其对宫颈癌预后的意义。结果 X^2检验结果显示：PNI与淋巴结转移、切缘累及、宫旁浸润、间质浸润深度及淋巴血管间隙浸润均显著相关。单因素分析显示：PNI（＋）组患者的中位生存时间及5年生存率低于PNI（一）组患者（P=0．042）。多因素COX回归分析显示神经侵袭不是影响宫颈癌术后患者生存的独立预后因素（P=0．628）。结论宫颈癌神经侵袭与宫颈癌患者预后有关，但尚不能作为判断宫颈癌术后预后不良的独立指标。

Objective To investigate the relation between perineural invasion （PNI） and prognosis of cervical cancer. Methods The clinical data of 165 patients with early-stage cervical cancer （stages Ⅰ A2-ⅡA2） who underwent radical hysterectomy and pelvic lymphadenectomy between 2002 and 2012 were analyzed. The relation between perineural invasion and clinical pathological parameters, and its significance to the prognosis of cervical cancer were investigated. Results Perineural invasion was significantly related lymph node metastasis, resection margin involvement, depth of primary tumor invasion, depth of stromal invasion and lympho vascular space invasion （x^2 text, P〈0.05）. The median survival time and 5-year survival rate of the PNI-positive patients were lower than those of PNl-negative patients in univariate analysis （P=0.042）, which were closely related with the prognosis of the patients. Multivariate analysis showed that perineural invasion was not an independent prognostic factor for the survival of patients with gastric cancer postoperative （P=0.628）. Conclusion PNI is associated with the prognosis of patients with cervical cancer. But it can not be used as an independent prognostic factor to determine the prognosis of patients with but cancer.