早期宫颈癌淋巴结转移高危因素的探讨

Analysis of High Risk Factors of Early-stage Cervical Cancer with Pelvic Lymph Node Metastasis

目的：统计分析Ⅰa2和Ⅰb1期宫颈癌的临床病理特征,探讨其盆腔淋巴结转移的高危因素。方法：回顾性分析2011年1月—2013年6月期间在天津市中心妇产科医院治疗的117例Ⅰa2、Ⅰb1期宫颈癌患者的临床资料。使用卡方检验及多元Logistic回归方法分析淋巴结转移的高危因素。结果：117例患者中15例（12.8%）发生淋巴结转移,淋巴结未转移者102例（87.2%）。单因素分析结果：肌层浸润深度≥1/2、子宫下段受累、脉管内瘤栓阳性、肿瘤直径〉2 cm、治疗前宫颈鳞状上皮抗原（SCC-Ag）水平为影响Ⅰa2和Ⅰb1期宫颈癌淋巴结转移的因素（均P〈0.05）。多因素分析结果表明,影响淋巴结转移的独立危险因素为治疗前SCC-Ag≥1.5 ng/m L（OR=25.007,95%CI：2.342~250.021,P=0.008）。结论：治疗前SCC-Ag水平是影响Ⅰa2和Ⅰb1期宫颈癌淋巴结转移的高危因素。

Objective：A statistical analysis was performed of the clinicopathology of stages Ⅰa2 and Ⅰb1 cervical cancer to analyse high risk factors of pelvic lymph node metastasis. Methods：A retrospective analysis was conducted of clinical data of a total of 117 patients with stage Ⅰa2 or Ⅰb1 cervical cancer who were hospitalized in Tianjin Central Hospital of Gynecology Obstetrics from January 2011 to June 2013. Use the χ~2 test and logistic regression to analyse the high risk factors of pelvic lymph node. Results：Of the 117 patients, there were 15（12.8%） and 102（87.2%） with and without lymphatic metastasis, respectively.Findings of univariate analysis showed that depth of myometrial invasion ≥1/2, lower uterine segment involvement, positive intravascular tumor thrombosis, tumor size 〉2 cm and level of SCC-Ag before treatment were influencing factors for early-stage lymphatic metastasis of cervical cancer（all P〈0.05）. Findings of multivariate analysis showed that SCC-Ag ≥1.5 ng/m L was the independent influencing factor for lymphatic metastasis（OR=25.007, 95%CI： 2.342~250.021, P=0.008）. Conclusions：Level of SCC-Ag before treatment was the high risk factor for pelvic lymph node metastasis of stages Ⅰa2 and Ⅰb1 cervical cancer.