早期子宫颈癌宫旁转移相关危险因素探讨

Risk factors of parametrial involvement in early stage cervical cancer

目的探讨早期子宫颈癌宫旁转移的相关危险因素,为其手术切除范围的缩小提供一定理论基础。方法回顾性分析890例子宫颈癌患者的临床资料,临床分期均为ⅠA2~ⅡA2期,均行广泛性子宫切除＋盆腔淋巴结清扫术,对资料进行单因素分析和多因素分析,找出与早期子宫颈癌宫旁转移相关的危险因素。结果术后病理检查提示,宫旁转移率为6.0%（53/890）。通过单因素分析发现,临床分期、肿瘤大小、血SCC-Ag水平、肿瘤浸润深度、脉管浸润、手术切缘状态、淋巴结转移、累及宫体、累及阴道是早期子宫颈癌宫旁转移的危险因素（均P〈0.05）。多因素分析发现,肿瘤间质浸润深度、脉管浸润、淋巴结转移是早期宫旁转移的独立危险因素（均P〈0.01）。结论肿瘤子宫颈浸润深度、脉管侵犯、淋巴结转移为子宫颈癌早期宫旁转移的独立危险因素。

Objective To evaluate the risk factors of parametrial involvement in early stage cervical cancer. Methods The clinical data of 890 patients with ⅠA2-ⅡA2 stage cervical cancer,who underwent extensive hysterectomy and pelvic lymph node dissection,were retrospectively analyzed. Univariate and multivariate analyses were conducted to determine the risk factors associated with parametrial metastasis in early cervical cancer. Results Postoperative pathological biopsy suggested that the rate of parametrial metastasis was 6. 0%（ 53 /890）. Univariate analysis showed that clinical stage,tumor size,serum SCC-Ag level,tumor invasion depth,vascular invasion,surgical margin status,lymph node metastasis,involvement of uterine body and involvement of the vagina were associated with parametrial involvement in early cervical cancer（ P〈0. 05）. Multivariate analysis suggested that tumor mesenchyme invasion depth,vascular invasion and lymph node metastasis were independent risk factors of parametrial metastasis in early stage cervical cancer（ P〈0. 01）. Conclusion The depth of tumor invasion in cervix,vascular invasion and lymph node metastasis are risk factors of parametrial metastasis in early stage cervical cancer.