老年宫颈癌患者淋巴结转移及术后盆腔感染危险因素分析

Risk Factors Analysis of Lymph Node Metastasis and Pelvic Infections in Elderly Patients with Cervical Cancer

目的回顾性研究探讨老年宫颈癌患者中影响淋巴结转移的相关因素及术后发生盆腔感染的高危因素。方法选择2011年8月～2015年1月在浙江省肿瘤医院接受手术治疗并有完整临床相关资料的324例老年宫颈癌患者，分析影响其发生淋巴结转移及术后盆腔感染的高危因素。结果324例患者的淋巴结转移率为19．8％，术后盆腔感染率为7．1％。单因素分析显示，FIGO分期、宫旁组织浸润、深肌层浸润、脉管内瘤栓、术前血清SCC—Ag、CA125均与淋巴结转移明显相关（P〈0．05）。Logistic回归多因素分析显示，FIGO临床分期Ⅱ期、深肌层浸润、脉管瘤栓与淋巴结转移有明显相关性。在盆腔感染的单因素分析中显示，开腹手术、术前有盆腔感染史、术后盆腔淋巴结囊肿是发生术后盆腔感染的危险因素（P〈0．05）。多因素分析显示，术前有盆腔感染史和术后盆腔淋巴囊肿与患者术后发生盆腔感染明显相关。结论FIGO临床分期Ⅱ期、深肌层浸润、脉管瘤栓是判断淋巴结转移的独立因素。术前有盆腔感染史和术后盆腔淋巴囊肿是患者术后发生盆腔感染的独立危险因素。

Objective To explore the risk factors of lymph node metastasis and pelvic infections after surgery in elderly patients with cervical cancer （ ≥60years）. Methods Clinical data of 324 pathologically confirmed cervical cancer patients in Zhejiang Cancer Hospi- tal from August 2011 to January 2015 were selected. Results The lymph node metastasis rate of elderly patients with cervical cancer waslg. 8% and the pelvic infections rate was 7.1%. In univariate lymph node metastasis analysis, the risk factors included clinical stage, positive parametrinm, deep stromal invasion, lymph vascular space involvement, serum squamous cell carcinoma antigen （SCC -Ag） and CA - 125 before treatment （P 〈 0.05 ）. However, the independent risk factors included clinical stage, deep stromal invasion and lymph vascular space involvement （P 〈 0.05）. In addition, univariate analysis showed that open operation way, preoperative pelvic infection history and postoperative indwelling cathete were associated with pelvic infections （ P 〈 0.05 ）. Factors predictive of pelvic infection on lo- gistic forward regression were preoperative pelvic infection history and postoperative indwelling catheter. Conclusion Clinical stage, deep stromal invasion and lymph vascular space involvement areindependent risk factors for lymph node metastasis in elderly patients with cervical cancer, preoperative pelvic infection history and postoperative indwelling catheter are independentrisk factors for pelvic infection after surgery.